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Schedule

(Substituted by Act 11 of 1997)

FORM 1

(Section 4)

APPLICATION FOR PROTECTION ORDER/INTERIM PROTECTION ORDER

SAINT LUCIA

In the Quarter of .........................................................................................
I .....................................................................................................................
(Name of Applicant)
of ...................................................................................................................
(Address)
........................................ hereby apply under section 4 of the Domestic Violence (Summary Proceedings) Act for a Protection Order/Interim Protection Order to be made by the magistrate against ..................................................
(Name of respondent)
who is .............................................................................................................
(Specify relationship to the named respondent)
and who resides at ...........................................................................................
(Specify address of respondent)
in respect of the following conduct. (Specify details of alleged conduct.)

........................................................

Applicant

Dated .......................................... 20 .........

FORM 2

(Section 7)

APPLICATION FOR OCCUPATION ORDER/INTERIM OCCUPATION ORDER

SAINT LUCIA

In the Quarter of .........................................................................................
I .....................................................................................................................
(Name of Applicant)
of ...................................................................................................................
(Address)
........................................ hereby apply under section 7 of the Domestic Violence (Summary Proceedings) Act for an Occupation Order/Interim Occupation Order to be made by the magistrate against ..................................................
(Name of respondent)
who is .............................................................................................................
(Specify relationship to the named respondent)
and who resides at ...........................................................................................
(Specify address of respondent)
in respect of the following conduct. (Specify details of alleged conduct.)

........................................................

Applicant

Dated .......................................... 20 .........

FORM 3

(Sections 3 (4) and 11)

APPLICATION FOR TENANCY ORDER/INTERIM TENANCY ORDER

SAINT LUCIA

In the Quarter of .........................................................................................
I .....................................................................................................................
(Name of Applicant)
of ...................................................................................................................
(Address)
........................................ hereby apply under section 3(4)/section 11 of the Domestic Violence (Summary Proceedings) Act for a Tenancy Order/Interim Tenancy Order to be made by the magistrate against ..................................................
(Name of respondent)
who is .............................................................................................................
(Specify relationship to the named respondent)
and who resides at ...........................................................................................
(Specify address of respondent)
in respect of the following conduct. (Specify details of alleged conduct.)

........................................................

Applicant

Dated .......................................... 20 .........

FORM 4

(Sections 4, 7, 11, and 12)

NOTICE OF PROCEEDINGS

SAINT LUCIA

In the Quarter of .........................................................................................
Between

................................................................................
Applicant
and
................................................................................
Respondent

To the Respondent

An application under section 4/section 7/section 11/section 12 of the Domestic Violence (Summary Proceedings) Act for a Protection Order/Interim Protection Order/Occupation Order/Interim Occupation Order/Tenancy Order/Interim Tenancy Order has been made by ........................................ against you. A copy of the application is attached. The application has been set down for hearing on ........................................ 20 ................, at (time) ................................. at ........................... (place).

If you do not appear in person at the hearing of the application, the Court may:

(a) deal with the application in your absence; or

(b) issue a warrant for your arrest to be brought before the Court.

...................................................................

Clerk of the District Court/Family Court.

Dated ................................ 20 ...........

FORM 5
AFFIDAVIT FOR USE IN PROVING SERVICE OF PROCESS
SAINT LUCIA
No. .....................
Return of service of process in respect of Domestic Violence Offence for the Court.
*Name of Applicant*	*Name of Respondent*	*Document Served*	*Date of Service*	*Place of Service*	*Mode of Service*





I do swear that the above Return of Service is true and in accordance with the fact of such Service.
..........................................................
(Deponent)
Sworn before me the above-named Deponent this ............. day of ............................................. 20.............
..........................................................
Magistrate or Justice (as the case may be)

FORM 6

(Section 6)

APPLICATION FOR VARIATION OR REVOCATION OF PROTECTION ORDER OR INTERIM PROTECTION ORDER

SAINT LUCIA

In the Quarter of .........................................................................................

Between

................................................................................

Applicant

and

................................................................................

Respondent

I .....................................................................................................................

(Name of Applicant)

hereby apply under section 6 of the Domestic Violence (Summary Proceedings) Act for a variation/revocation of the order made against

.......................................................................................................................

(Name of person against whom the Order was made)

on ........................................ by the ........................................ Court (a copy of which is attached to the said application) in respect of certain conduct or threatened conduct towards ........................................

................................................................................

(Name of person who is protected by order)

There has been no previous proceedings in any court in respect of the said order and I now ask for a revocation or variation of that order to be made.

Specify details of variation

......................................................................

Applicant

Dated ............................., 20 ...........

FORM 7

(Section 10)

APPLICATION FOR VARIATION OR REVOCATION OF OCCUPATION ORDER OR INTERIM OCCUPATION ORDER

SAINT LUCIA

In the Quarter of .........................................................................................
Between

................................................................................
Applicant
and
................................................................................
Respondent

I .....................................................................................................................

(Name of Applicant)

hereby apply under section 10 of the Domestic Violence (Summary Proceedings) Act for a variation/revocation of the order made against

(Name of person against whom the order was made)

on .................................... by the ........................................ Court (a copy of which is attached to the said application) in respect of certain conduct or threatened conduct towards

.......................................................................................................................

(Name of person who is protected by order)

There has been no previous proceedings in any court in respect of the said order and I now ask for a revocation or variation of that order to be made.

Specify details of variation

......................................................................

Applicant

Dated ............................., 20 ...........

FORM 8

(Section 14)

APPLICATION FOR VARIATION OR REVOCATION OF TENANCY ORDER OR INTERIM TENANCY ORDER

SAINT LUCIA

In the Quarter of .........................................................................................
Between

................................................................................
Applicant
and
................................................................................
Respondent

I .....................................................................................................................

(Name of Applicant)

hereby apply under section 14 of the Domestic Violence (Summary Proceedings) Act for a variation/revocation of the order made against

.......................................................................................................................

(Name of person against whom the order was made)

on ................................... by the .............................................. Court (a copy of which is attached to the said application) in respect of certain conduct or threatened conduct towards

.......................................................................................................................

(Name of person who is protected by order)

There has been no previous proceedings in any court in respect of the said order and I now ask for a revocation or variation of that order to be made.

Specify details of variation

......................................................................

Applicant

Dated ............................., 20 ...........

FORM 9

(Section 4)

PROTECTION ORDER OR INTERIM PROTECTION ORDER

SAINT LUCIA

In the Quarter of .........................................................................................

The Court having heard an application made by .............................................
.......................................................................................................................

(Name of Applicant)

towards ...........................................................................................................

(Name of person to be protected)

Now the Court this day orders that, for (period):

1. (Name of Respondent) shall not engage in the following conduct;

2. (Name of Respondent) shall not engage in conduct that constitutes a domestic violence offence;

3. (Name of Respondent) shall comply with the following prohibitions and conditions.

Specify prohibitions and conditions and any period or periods for which they may be imposed.

..................................................................

Clerk of the District Court/Family Court

Dated ..............................., 20 ............

FORM 10

(Section 7)

OCCUPATION ORDER OR INTERIM OCCUPATION ORDER

SAINT LUCIA

In the Quarter of .........................................................................................

(Name of Applicant)

towards ...........................................................................................................

(Name of person to be protected)

Now the Court this day orders that, for (period):

1. (Name of Respondent) shall not engage in the following conduct;

2. (Name of Respondent) shall not engage in conduct that constitutes a domestic violence offence;

3. (Name of Respondent) shall comply with the following prohibitions and conditions.

Specify Prohibitions and Conditions and any period or periods for which they may be imposed.

................................................

Clerk of the District Court.

Dated ..............................., 20 ............

FORM 11

(Sections 3(4), 11 and 12)

TENANCY ORDER OR INTERIM TENANCY ORDER

SAINT LUCIA

In the Quarter of .........................................................................................

(Name of Applicant)

towards ...........................................................................................................

(Name of person to be protected)

Now the Court this day orders that, for (period):

1. (Name of Respondent) shall not engage in the following conduct;

2. (Name of Respondent) shall not engage in conduct that constitutes a domestic violence offence;

3. (Name of Respondent) shall comply with the following prohibitions and conditions.

Specify Prohibitions and Conditions and any period or periods for which they may be imposed.

................................................

Clerk of the District Court.

Dated ..............................., 20 ............

FORM 12

(Section 6)

ORDER VARYING PROTECTION ORDER OR INTERIM PROTECTION ORDER

SAINT LUCIA

In the Quarter of .........................................................................................

The Court, having heard an application made under section 6 of the Domestic Violence (Summary Proceedings) Act
.......................................................................................................................

(Name of Applicant)

in respect of the conduct or threatened conduct of ...............................................
........................................................................................................................

(Name of Respondent)

towards ............................................. and having on

(name of person to be protected)

............................................. orders that for (period):

(Date of original order)

1. (Name of Respondent) shall not engage in the following conduct;

2. (Name of Respondent) shall not engage in conduct that constitutes a domestic violence offence;

3. (Name of Respondent) shall comply with the following prohibitions and conditions.

(Specify prohibitions and conditions and any other period or periods for which they may be imposed).

Now the Court on the application of (Name of Applicant) this day orders that the Protection Order or (Interim Protection Order) be varied as follows:

(Specify details of variation)

................................................

Clerk of the District Court.

Dated ..............................., 20 ............

FORM 13

(Section 10)

ORDER VARYING OCCUPATION ORDER OR INTERIM OCCUPATION ORDER

SAINT LUCIA

In the Quarter of .........................................................................................

The Court, having heard an application made under section 10 of the Domestic Violence (Summary Proceedings) Act
......................................................................................................................

(Name of Applicant)

(Name of Respondent)

towards ....................................................... and having on

(name of person to be protected)

............................................. orders that for (period):

(Date of original order)

1. (Name of Respondent) shall not engage in the following conduct;

2. (Name of Respondent) shall not engage in conduct that constitutes a domestic violence offence;

3. (Name of Respondent) shall comply with the following prohibitions and conditions.

(Specify prohibitions and conditions and any other period or periods for which they may be imposed).

Now the Court on the application of (Name of Applicant) this day orders that the Occupation Order or (Interim Occupation Order) be varied as follows:

(Specify details of variation)

................................................

Clerk of the District Court.

Dated ..............................., 20 ............

FORM 14

(Section 14)

ORDER VARYING TENANCY ORDER OR INTERIM TENANCY ORDER

SAINT LUCIA

In the Quarter of .........................................................................................

The Court, having heard an application made under section 14 of the Domestic Violence (Summary Proceedings) Act
.......................................................................................................................

(Name of Applicant)

in respect of the conduct or threatened conduct of .............................................
.......................................................................................................................

(Name of Respondent)

towards ................................................................................... and having on

(name of person to be protected)

............................................. order that for (period):

(Date of original order)

1. (Name of Respondent) shall not engage in the following conduct;

2. (Name of Respondent) shall not engage in conduct that constitutes a domestic violence offence;

3. (Name of Respondent) shall comply with the following prohibitions and conditions.

(Specify prohibitions and conditions and any other period or periods for which they may be imposed).

Now the Court on the application of (Name of Applicant) this day orders that the Tenancy Order or (Interim Tenancy Order) be varied as follows:

(Specify details of variation)

................................................