Newfoundland and Labrador Gazette, Part II — 2 June 2017, Vol. 92, No. 22 — Regulations NLR 71/98

NLG 2017-06-02

Newfoundland and Labrador — Gazette

Vol. 92 ST. JOHN’S, FRIDAY , JUNE 2, 2017 No. 22 THE NEWFOUNDLAND AND LABRADOR GAZETTE

PART I PUBLISHED BY AUTHORITY MINERAL ACT NOTICE Mineral rights to the following mineral licenses have reverted to the Crown: A portion of license 015137M Held by Champion Iron Mines Limited Situate near Powderhorn Lake, Central NL On map sheet 12H/01 more particularly described in an application on file at Department of Natural Resources. Mineral License 015136M Held by Champion Iron Mines Limited Situate near Powerhorn Lake, Central NL On map sheet 12H/01 Mineral License 016572M Held by Tata Steel Minerals Canada Ltd.

Situate near Gilling Lake On map sheet 23J/10 Mineral License 017332M Held by Alterra Resources Inc. Situate near St Lewis Inlet On map sheet 03D/05 Mineral License 023073M Held by Bowmore Exploration Ltd. Situate near La Scie, Baie Verte Peninsula On map sheet 02E/13 Mineral License 022876M Held by Hicks, Darrin Situate near Winter Hill, Southern NL On map sheet 01M/12 Mineral License 022934M Held by 7980736 Canada Inc.

Situate near Harbour Round Pond, Central NL On map sheet 12A/10 Mineral License 023758M Held by Hicks, Darrin Situate near Roti Bay, Southern NL On map sheet 01M/13 Mineral License 023759M Held by Stockley, Mark Situate near Adlatok River Area On map sheet 13N/06 Mineral License 023761M Held by Northcott, Edwin Situate near Seal Brook, Southern NL On map sheet 11P/12 173 NOTE: Attached to the end of

Part II is a list of Statutes of Newfoundland and Labrador, 2017 as enacted up to May 31, 2017.

Mineral License 023763M Held by Kenny, Albert Situate near Fermeuse, Avalon Peninsula On map sheet 01K/15, 01K/14 Mineral License 023764M Held by Kenny, Albert Situate near Big Bough Place, Avalon Peninsula On map sheet 01K/14 Mineral License 023766M Held by Gardner, Art Situate near Great Gull Lake, Central NL On map sheet 12H/01 The lands covered by this notice except for the lands within Exempt Mineral Lands, the Exempt Mineral Lands being described in CNLR 1143/96 and NLR 71/98, 104/98, 97/00, 36/01, 31/04, 78/06, 8/08, 28/09 and 5/13 and outlined on 1:50 000 scale digital maps maintained by the Department of Natural Resources, will be open for staking after the hour of 9:00 a.m. on the 32 nd clear day after the date of this publication.

DEPARTMENT OF NATURAL RESOURCES Justin Lake, Manager - Mineral Rights File #’s 774: 5677, 6185, 8251; 775: 0888, 3673, 4317, 4914, 4931, 5486, 5487, 5489, 5491, 5492, 5493. Jun 2 LANDS ACT NOTICE OF INTENT,

SECTION 7 LANDS ACT, SNL1991 c36 AS AMENDED NOTICE IS HEREBY given that an application has been made to the Department of Fisheries and Land Resources, Agriculture and Lands Branch, to acquire title, pursuant to

section 7(2) (

a) of the said Act, to that piece of Crown lands situated within 15 metres of the waters of Cremaillere Harbour for the purpose of a Industrial Subdivision Water Lots. The land is described as follows (to the extent of the intrusion on the reservation): Bounded on the North by Goose Cove Road (Route 430); Bounded on the East by Atlantic Ocean; Bounded on the South by Town of St. Anthony (Crown land); Bounded on the West by Hare Bay (Crown land); and, containing an area of approximately 72,450 square metres.

Any person wishing to object to the application must file the objection in writing with reasons, within 30 days from the publication of the notice on the Department of Fisheries and Land Resources website, Crown Lands, http://www. ma.gov.nl.ca/lands/index.html, to the Minister of Fisheries and Land Resources by mail or email to the nearest Regional Lands Office: ● Eastern Regional Lands Office, P.O. Box 8700, Howley Building, Higgins Line, St. John’s, NL, A1B 4J6 Email: easternlandsoffice@gov.nl.ca ● Central Regional Lands Office, P.O.

Box 2222, Gander, NL, A1V 2N9 Email: centrallandsoffice@gov.nl.ca ● Western Regional Lands Office, P.O. Box 2006, Sir Richard Squires Building, Corner Brook, NL, A2H 6J8 Email: westernregionlands@gov.nl.ca ● Labrador Regional Lands Office, P.O.

Box 3014, Station “B”, Happy Valley-Goose Bay, NL, A0P 1E0 Email: labradorlandsoffice@gov.nl.ca (DISCLAIMER: The Newfoundland and Labrador Gazette publishes a NOTICE OF INTENT received from the Applicant and takes no responsibility for errors or omissions in the property being more particularly described.) Jun 2 QUIETING OF TITLES ACT 2017 03G 0079 IN THE SUPREME COURT OF NEWFOUNDLAND AND LABRADOR TRIAL DIVISION (GENERAL) IN THE MATTER OF the the Quieting of Titles Act, RSNL1990 cQ-3, as amended, AND IN THE MATTER OF all that piece or parcel of land situate and being at West Bottom, in the Province of Newfoundland and Labrador, AND IN THE MATTER OF an Application by CAMERON YOUNG and GOLDA YOUNG , both of the Town of Springdale, in the Province of Newfoundland and Labrador.

NOTICE OF APPLICATION under the Quieting of Titles Act, RSNL1990 cQ-3, as amended. NOTICE IS HEREBY GIVEN to all parties that CAMERON YOUNG and GOLDA YOUNG , both of the Town of Springdale, in the Province of Newfoundland and Labrador, have applied to the Supreme Court of Newfoundland and Labrador, Trial Division (General), Judicial Centre of Grand Falls -Windsor, to have title to all that piece or parcel of land situate at West Bottom, in the Province of Newfoundland and Labrador, and being more particularly described in

Schedule “A” hereto annexed and shown in

Schedule “B” hereto annexed, investigated and for a declaration that said Applicants are the absolute owners thereof. THE NEWFOUNDLAND AND LABRADOR GAZETTE June 2, 2017 174

All persons having title adverse to the title claimed by the Applicants shall file in the Registry of the Supreme Court of Newfoundland and Labrador, Trial Division (General), Judicial Centre of Grand Falls-Windsor, particulars of such adverse claim and serve the same together with an Affidavit verifying the same on the undersigned Solicitor for the Applicants on or before the 4 th day of July, 2017, after which date no party having any claim shall be permitted to file the same or to be heard except with special leave of the Court and subject to such conditions as the Court may deem just.

All adverse claims shall be investigated in such manner as the Supreme Court of Newfoundland and Labrador, Trial Division (General) may direct. DATED AT the Town of Springdale, in the Province of Newfoundland and Labrador, this 24 th day of May, 2017. SHAWN COLBOURNE LAW OFFICE Solicitor for the Applicants PER: Shawn Colbourne, QC ADDRESS FOR SERVICE: P.O. Box 69, 8 Juniper Road Springdale, NL A0J 1T0 Tel: (709) 673-3693 Fax: (709) 673-3991

SCHEDULE "A" Description of land for Cameron Young West Bottom, NL All that piece or parcel of land situate and being at West Bottom, in the Electoral District of Baie Verte -Green Bay, Province of Newfoundland and Labrador, abutted and hounded as follows, that is to say: Beginning at a found capped iron bar located on the northerly limit of the Reservation, ten decimal zero six metres wide, extending along the northerly shoreline of the Waters of Hall’s Bay and marking a southeasterly comer of a Crown Grant issued to George Brown or assigns as registered in V olume 105, Folio 155, in the Registry of Crown Grants for Newfoundland and having coordinates of north 5478329.396 metres and east 296119.259 metres; Thence running by the said land contained within a Crown Grant issued to George Brown or assigns as registered in V olume 105, Folio 155, in the Registry of Crown Grants for Newfoundland north thirty-one degrees forty-six minutes twenty-two seconds west four hundred ninety-four decimal zero one two metres; Thence running by Crown Land north fifty-eight degrees thirteen minutes thirty-eight seconds east one hundred seventy-nine decimal zero two one metres; Thence running by Crown Land south thirty-one degrees forty-six minutes twenty-two seconds east four hundred seventy-eight decimal one six five metres; Thence running one hundred eighty-three metres, more or less, along the northerly limit of the Reservation, ten decimal zero six metres wide, extending along the northerly shoreline of the Waters of Hall’s Bay to the point of beginning which bears south fifty-three degrees ten minutes seven seconds west one hundred seventy-nine decimal seven two one metres, from the preceding point; Reserving, nevertheless, out of the above described parcel of land a Road Reserve, twenty decimal one two metres wide, which extends across the said property.

The above described parcel of land being subject to a an Existing Trail, three metres wide, which extends across the said property being more particularly shown on the diagram annexed hereto; Containing an area of eight decimal four nine seven hectares, more or less, and being more particularly shown on the diagram annexed hereto; All bearings being referred to the meridian of fifty-six (56°) west longitude of the Modified Three Degree Transverse Mercator Projection (NAD 83), Zone 2, and all distances shown being horizontal ground distances. August 5, 2016 THE NEWFOUNDLAND AND LABRADOR GAZETTE June 2, 2017 175

Jun 2 THE NEWFOUNDLAND AND LABRADOR GAZETTE June 2, 2017 176

TRUSTEE ACT ESTATE NOTICE IN THE MATTER OF the Estate of WILLIAM JAMES HICKEY , Late of O’Donnells, in the Province of Newfoundland and Labrador, Deceased. All persons claiming to be creditors of, or who have any claims or demands either as beneficiaries or next-of-kin (by full or half blood, legal adoption or marriage) upon or affecting, the Estate of WILLIAM JAMES HICKEY who died at St. John’s, NL on or about June 30, 2016 are hereby requested to send particulars thereof in writing, duly attested, to: Office of the Public Trustee, Viking Building, Suite 401 - 136 Crosbie Road, St. John’s, NL A1B 3K3.

Particulars will be received by the Public Trustee, as Executor of the Estate of WILLIAM JAMES HICKEY on or before July 3, 2017, after which date the said Executor will proceed to distribute the Estate having regard only to the claims of which he then shall have had notice. DATED AT the City of St. John’s, in the Province of Newfoundland and Labrador, this 2 nd day of June, 2017. OFFICE OF THE PUBLIC TRUSTEE Administrator of the Estate of WILLIAM JAMES HICKEY ADDRESS FOR SERVICE: Viking Building Suite 401 - 136 Crosbie Road St.

John’s, NL A1B 3K3 Tel: (709) 729-0850 Fax: (709) 729-3063 Jun 2 ESTATE NOTICE IN THE MATTER OF the Estate of BARBARA JOHNSON, Late of St. John’s in the Province of Newfoundland and Labrador, Deceased. All persons claiming to be creditors of, or who have any claims or demands either as beneficiaries or next-of-kin (by full or half blood, legal adoption or marriage) upon or affecting, the Estate of BARBARA JOHNSON who died at St.

John’s, NL on or about January 3, 2016, are hereby requested to send particulars thereof in writing, duly attested, to: Office of the Public Trustee, Viking Building, Suite 401 - 136 Crosbie Road, St. John’s, NL A1B 3K3. Particulars will be received by the Public Trustee, as Executor of the Estate of BARBARA JOHNSON , on or before June 30, 2017, after which date the said Executor will proceed to distribute the Estate having regard only to the claims of which he then shall have had notice. DATED at the City of St. John’s, in the Province of Newfoundland and Labrador, this 24th day of May, 2017.

OFFICE OF THE PUBLIC TRUSTEE Administrator of the Estate of BARBARA JOHNSON ADDRESS FOR SERVICE: Viking Building Suite 401 - 136 Crosbie Road St. John’s, NL A1B 3K3 Tel: (709) 729-0850 Fax: (709) 729-3063 Jun 2 THE NEWFOUNDLAND AND LABRADOR GAZETTE June 2, 2017 177

Vol. 92 ST. JOHN’S, FRIDAY , JUNE 2, 2017 No. 22 THE NEWFOUNDLAND AND LABRADOR GAZETTE

PART II SUBORDINATE LEGISLATION FILED UNDER THE STATUTES AND SUBORDINATE LEGISLATION ACT NEWFOUNDLAND AND LABRADOR REGULATIONS NLR 47/17 NLR 48/17

NEWFOUNDLAND AND LABRADOR REGULATION 47/17 Rules of Supreme Court, 1986 (Amendment) under the Judicature Act (Filed May 30, 2017) Under the authority of

section 55 of the Judicature Act, the Rules Committee of the Trial Division makes the following Rules. Dated at St. John’s, May 23, 2017. Raymond P. Whalen Chairperson, Rules Committee REGULATIONS Analysis 1. Rule F8.04 Amdt. 2. Forms F R&S 1. Rule F8.04(1) of the Rules of the Supreme Court, 1986 is amended by (

a) deleting the word "or" immediately following "(4)" and replacing it with a comma; and (

b) adding the words, parentheses and number "or (6)" immediately following "5". 2. The rules are amended by re pealing and substituting the following Forms: F4.03A; F4.04A; F4.04B; F5.05A; F5.06A; 627 The Newfoundland and Labrador Gazette June 2, 2017

Rules of Supreme Court, 1986 (Amendment) 47/17 F6.02A; F6.04A; F6.06A; F7.02A; F8.04A; F8.11A; F10.02A; F10.04A; F11.02A; F11.02B; F11.03A; F11.03B; F14.04A; F16.03A; F17.03A; F18.03A; F19.02A; F23.01A; F23.02A; F23.05A; F25.03A; F26.02A; F26.03A; F27.02A; F28.02A; F29.02A; F31.02A; F34.02A; F34.02B; F34.02C; F38.04A; F38.04B; F38.06A; and F40.04A. 628 The Newfoundland and Labrador Gazette June 2, 2017

Originating Application (Family Law) – Instructions for the Applicant Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 1 of 1 How to Make an Originating Application Instructions for the Applicant An Originating Application (Form 4.03A) is a document you must use to start a family law court proceeding. Your Originating Application tells the Court that there are family law issues that you would like to have resolved. If you start an Originating Application, you are the Applicant. The other person is the Respondent.

If you are making an application together with the other person (ie. a joint application), you cannot use this form. You must do a Joint Originating Application (Form F4.04A). Completing Your Originating Application You can fill out this form by hand or you can download and fill out this form electronically at www.court.nl.ca/supreme/family/forms.html (If you fill out the form electronically, you must still print the form, file it with the Court, and serve a copy on the Respondent). You must fill out pages 1-5 of the Originating Application and attach any schedules and additional forms that apply to you.

If you need more space to fill out any

section of this Originating Application, attach an extra page and indicate which

section is continued on the extra page. Filing Your Originating Application You must make 3 extra copies of your completed and signed Originating Application (including any additional documents). To file your Originating Application, you can either bring it to a Supreme Court location near you or you can mail it to a Supreme Court location near you (with the filing fee attached). You can look up the fees online: www.court.nl.ca/supreme/fees.html Serving Your Originating Application You must give a copy of the Originating Application to the Respondent. This is called service.

You have 180 days to serve the Respondent after you have filed the Application. If you do not serve the Application in 180 days, it will expire and you may have to file a new Originating Application. If your Application involves divorce and/or parenting, an adult (who is not you) must hand-deliver the Application to the Respondent. This is called personal service . You will have to file an Affidavit of Service (Form F8.11A) with the Court.

If your Application does not involve divorce or parenting, you can serve the Respondent by personal service, leaving a copy with the Respondent’s lawyer, leaving a copy at the Respondent’s address, registered mail/courier, or regular mail. You can also serve by fax, email, or electronic docum ent exchange, if the Respondent has provided that information. You will have to file an Affidavit of Service (Form F8.11A) , Acknowledgement of Service (Form F8. 04A), a copy of the document with the recipient’s lawyer’s endorsement on it, a reply email, or a delivery confirmation with the Court. More Information Questions?

Go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding or getting a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 --- REMOVE THIS PAGE BEFORE SERVING THE APPLICATION ON THE RESPONDENT --- 629 The Newfoundland and Labrador Gazette June 2, 2017

Originating Application (Family Law) – Instructions for the Respondent Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 1 of 1 How to Respond to an Originating Application Instructions for the Respondent A family law proceeding has been started against you. You are the Respondent in this proceeding. The person who has started this family law proceeding is the Applicant. Read the attached Originating Application (Form 4.03A) carefully. The Applicant has explained the family law issues that he/she would like to have resolved.

If you want to oppose any of the Applicant’s claims or if you want to make your own claims, you must file and serve a Response (Form F6.02A). You can get a Response form at any Supreme Court location or online: www.court.nl.ca/supreme/family/forms.html You have only 30 days after this Originating Application has been served on you to file and serve your Response (You have 60 days if you have been served outside of Canada or the United States). For more information on how to fill out, file, and serve a Response, read the “Instructions for the Respondent” page attached to the Response form.

If you do not respond, the Court may proceed and make an order without hearing from you. More Information Questions? You can go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 630 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 1 Form F4.03A: Originating Application (Family Law) In the Supreme Court of Newfoundland and Labrador Trial Division (General/Family) FOR COURT USE ONLY COURT FILE NO: CENTRAL DIVORCE REGISTRY NO: Filed at _____________________________ , Newfoundland and Labrador, this ________ day of __________________, 20______.

Registry Clerk of the Supreme Court of Newfoundland and Labrador BETWEEN: APPLICANT (Print full name) AND: RESPONDENT (Print full name) AND: NOT APPLICABLE SECOND APPLICANT SECOND RESPONDENT (Print full name) You must start your application at the Court location that is closest to you or closest to the other party. However, if your family law matter involves parenting or child support, you must start your application at the Court location that is closest to where your children live.

Check off where your application is required to be heard and note the location where you must file your documents: If your application is required to be heard in… …then you must file your documents in… Clarenville (Grand Bank Circuit) Grand Bank Supreme Court Corner Brook Corner Brook Supreme (Family Division) Gander Gander Supreme Court Grand Bank Grand Bank Supreme Court Grand Falls – Windsor Grand Falls – Windsor Supreme Court Happy Valley – Goose Bay Happy Valley – Goose Bay Supreme Court Port aux Basques (Corner Brook Circuit) Corner Brook Supreme Court (Family Division) Rocky Harbour (Corner Brook Circuit) Corner Brook Supreme Court (Family Division) St.

Anthony (Corner Brook Circuit) Corner Brook Supreme Court (Family Division) St. John’s St. John’s Supreme Court (Family Division) Stephenville (Corner Brook Circuit) Corner Brook Supreme Court (Family Division) Wabush (Happy Valley – Goose Bay Circuit) Happy Valley – Goose Bay Supreme Court 631 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 2 Check the type of order(

s) that you are seeking: You must fill out the Schedule(

s) that relate to your claim(

s) and attach any additional forms or documents required. Type of Order Fill Out

Schedule Attach Divorce 1 Original marriage certificate Parenting (Decision-making and parenting time) 2 - Child Support 3 Financial Statement (Form F10.02A) and/or income information, if applicable Spousal (married) Support or Partner (unmarried) Support 4 Financial Statement (Form F10.02A) Parental Support (for parents) or Dependant Support (for spouse or child of deceased person) 4 Financial Statement (Form F10.02A) Division of Matrimonial (married) Property, Common Law (unmarried) Property, or Property under the FHRMIR Act 5 Property Statement (Form F10.02A) Return of Child (within Canada) 6 Emergency Interim Application (Form 17.03A) if applicable Consent Order or Agreement 7 Signed consent order or agreement Other: ___________________________________ 7 - Applicant Information Fill in your information below: If you have safety concerns and do not want to provide your contact information, you may provide alternate contact information below.

You must still provide the Court with your actual contact information in a sealed envelope. This envelope will not be available to the other party. Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Please note that if you provide your email address, the Court may contact you by email.

Date of Birth Month: Day: Year: 632 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 3 Occupation(

s) or Job(

If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) Respondent Information Fill in the Respondent’s information below (to the best of your knowledge): Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Date of Birth Month: Day: Year: Occupation(

s) or Job(

s) Citizen / Immigration Status Canadian Citizen Permanent Resident Foreign National Is the Respondent a registered Indian under the Indian Act? Yes No If yes, what is the name of the Respondent’s band? Does the Respondent live on a reserve? Does the Respondent need an interpreter? Yes No Please note that the Court is not responsible for any interpreter fees or arrangements. If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) 633 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 4 Fill in the information about your relationship with the Respondent: Your relationship with the Respondent Date the parties started living together Month: Day: Year: OR Not applicable Date of marriage Month: Day: Year: OR Not applicable Place of marriage OR Not applicable Prior to the marriage, you were Unmarried Divorced Widowed OR Not applicable Prior to the marriage, the Respondent was Unmarried Divorced Widowed OR Not applicable Date of separation Month: Day: Year: OR Not applicable Date of divorce Month: Day: Year: OR Not applicable Check this box if you are starting a proceeding against more than one Respondent.

Attach an extra page to provide the information of the other Respondent(

s) and the details of your relationship with the other Respondent(s). Fill in the information for every child of your relationship (Include children under and over 19 and non-dependent children): Child 1 Child 2 Child’s Full Name Mother’s Full Name Father’s Full Name Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs Child 3 Child 4 Child’s Full Name Mother’s Full Name Father’s Full Name Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs Check this box if there are no children.

Check this box if there are more than 4 children. Attach an extra page to provide the details of those children. 634 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 5 If child protection services have ever been involved with you, the Respondent(s), and/or the children, provide the details below. Provide the details of any current or ongoing court proceedings, court orders, and/or written agreements involving you, the Respondent(s), and/or the children. Attach any written agreements and any court orders not in the Court file. Statement of Truth You must swear or affirm that the facts and information that you have written in this Originating Application and the attached Schedule(

s) is the truth. You must swear or affirm and sign this Statement of Truth in front of a commissioner of oaths, notary public, justice of the peace, or lawyer. Court Registry staff are commissioners of oaths and you may sign this application at the Court when you file it. I declare the facts and information in this Originating Application are true to the best of my knowledge and belief. SWORN TO or AFFIRMED at _______________________, this _________ day of _________________ , 20_____ .

Signature of Applicant Signature of Person Authorized to Administer Oaths Lawyer’s Signature for Fee Waiver I am employed by the Newfoundland and Labrador Legal Aid Commission or a Newfoundland and Labrador government department under the Executive Council Act and I am the lawyer of record in this matter. Signature of Lawyer (if any) Print Name of Lawyer (if any) Lawyer’s Certificate Check this box if you have a lawyer. Your lawyer must complete this Certificate. If you are not applying for divorce or do not have a lawyer, you do not have to fill out this Certificate.

I, ____________________________________ , the Lawyer for ______________________________________ , (Print Lawyer’s Name) (Print Applicant’s Name) the Applicant, certify to this Court that I have complied with the requirements of s.9 of the Divorce Act. DATED at _________________________________, this __________ day of ____________________ , 20______ . Signature of Lawyer Address of Lawyer 635 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 6 (Note: This

Schedule is intended for divorce applications under the Divorce Act. If you are seeking a divorce under the Civil Marriages Act, fill out

Schedule 7.)

Schedule 1 Divorce In order to apply for a divorce, you must be able to satisfy all 4 of the requirements below: 1 There has been a breakdown in our marriage and there is no likelihood that we will get back together. 2 I am a resident of Newfoundland and Labrador and have been a resident of Newfoundland and Labrador for at least 1 year immediately prior to this application.

OR My spouse is a resident of Newfoundland and Labrador and has been a resident of Newfoundland and Labrador for at least 1 year immediately prior to this application. 3 I have attached the original Certificate of Marriage (or Registration of Marriage) to this Application. If you were married in Canada, you can obtain your Certificate of Marriage from the provincial Vital Statistics Agency. Check this box if your Certificate of Marriage is not in English or French. You must attach a translation.

OR I was married outside of Canada and I am unable to attach a copy of my Certificate of Marriage (or Registration of Marriage) because it is impossible or impractical to obtain. You will have to make an Interim Application for a Procedural Order (using Form F16.03A) for an Order dispensing with the need to file a Certificate of Marriage. 4 There has been no collusion in relation to this application for a divorce.

I am seeking a divorce because there has been a permanent breakdown in our marriage based upon: Separation: Check this box if you and your spouse currently live separate and apart and will have lived separate and apart for at least 1 year prior to the determination of the divorce proceeding. If you and your spouse have been living separate and apart for less than 1 year, you may still file an Originating Application for divorce on the ground of separation. However, you must wait until 1 year has elapsed to file an Application for Judgment for divorce.

Adultery: Check this box if you are seeking divorce because the Respondent has committed adultery. Attach an extra page with details of the adultery. You may be required to present further evidence of the adultery. You do not need to name any other person involved. If you choose to name another person, you must serve this Originating Application on that person by personal service. That other person(

s) will have the same rights as the Respondent in relation to the adultery claim and may file a Response. Check this box to declare that you have not condoned or connived in the adultery. Cruelty: Check this box if you are seeking divorce because your spouse has treated you with physical or mental cruelty that makes continued cohabitation intolerable. Attach an extra page with details of the cruelty. You may be required to present further evidence of the physical or mental cruelty. Check this box to declare that you have not condoned or connived in the cruelty. 636 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 7

Schedule 2 Parenting If you are making a parenting application (custody and/or access), fill in the information below: What are the current parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other contact (ie. phone or internet): Other important issues in relation to parenting the child(ren): 637 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 8 What are your proposed parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other contact (eg. phone, internet, etc.): Other important issues in relation to parenting the child(ren): 638 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 9

Schedule 3 Child Support Check all of the boxes that apply: I am seeking the basic table amount as per the Child Support Guidelines. I am seeking special and/or extraordinary expenses. You must complete and attach a Financial Statement (Form (F10.02A). I am seeking an amount of child support that is different from the Child Support Guidelines basic table amount. Depending on your reason(

s) for seeking an amount different from the Child Support Guidelines, you may have to attach further documentation. List your reason(

s) for seeking an amount of child support different from the Child Support Guidelines: The Respondent and I have agreed to child support in the amount of $ ______________ per month. I have physical custody of (or exercise access to) the child(ren) for 40% or more of the year. You must complete and attach a Financial Statement (Form F10.02A). The child(ren) is(are) 19 years of age or older. You must complete and attach a Financial Statement (Form F10.02A). One or more of the persons who is obligated to pay support has an income that is more than $150,000 annually.

You must complete and attach a Financial Statement (Form F10.02A). I am claiming undue hardship for the following reason(s): You must complete and attach a Financial Statement (Form F10.02A). Other: Depending on your claim, you may be required to complete and attach a Financial Statement (Form F10.02A). I am seeking retroactive child support. What is the amount of retroactive child support that you are seeking? $_______________________________ What is the date from which you are seeking retroactive child support? (month/day/year) ____________________ Describe the facts and your reason(

s) for seeking retroactive child support: 639 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 10

Schedule 4 Spousal, Partner, Parental, or Dependant Support If you are seeking spousal, partner, parental, or dependant support, you must complete and attach a Financial Statement (Form F10.02A) Check all of the boxes that apply and fill in the information required: I am seeking : Spousal support Partner support Parental support Dependant support Describe the facts and your reason(

s) for seeking support: I am seeking: Retroactive spousal support Retroactive partner support Retroactive parental support Retroactive dependant support What is the amount of retroactive support that you are seeking? $__________________________________ What is the date from which you are seeking retroactive support? (month/day/year) _______________________ Describe the facts and your reason(

s) for seeking retroactive support: 640 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 11

Schedule 5 Division of Property If you are seeking a division of matrimonial property or common law property, you must complete and attach a Property Statement (Form F10.04) Check all of the boxes that apply and fill in any information required: I am seeking an equal division of matrimonial property. I am seeking an unequal division of matrimonial property. Describe the facts and your reason(

s) for seeking an unequal division of property: I am seeking exclusive possession of the matrimonial home. Describe the facts and your reason(

s) for seeking exclusive possession of the matrimonial home: I am seeking a division of common law property. Describe your property claim, the facts, and your reason(

s) for seeking the claim: I am making a claim under the Family Homes on Reserves and Matrimonial Interests or Rights Act. Describe your property claim, the facts, and your reason(

s) for seeking the claim: Other: Describe your property claim, the facts, and your reason(

s) for seeking the claim: 641 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 12

Schedule 6 Return of Child (within Canada) If you are seeking a court order for the return of a child or children (within Canada), answer the questions below: You may provide any additional affidavit(

s) necessary. At what address does the child(ren) habitually (normally) live? Set out all of the available facts and information that you have relating to the whereabouts of the child(ren): Set out all the available facts and information that you have regarding the identity of the person that the child(ren) is/are presumed to be with: Set out your reasons for making the application: 642 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 13

Schedule 7 Other Applications If you are seeking a court order for something other than the claims requested in the other Schedules, state what you are seeking, describe the facts, and give reasons: 643 The Newfoundland and Labrador Gazette June 2, 2017

Joint Originating Application – Instructions for Co-Applicants Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 1 of 1 How to Make a Joint Originating Application Instructions for Co-Applicants You may use a Joint Originating Application (Form F4.04A) if you and the other person(

s) consent to your family law issues and want to apply for a family law order together. If you and the other person(

s) disagree on any family law issues, you cannot use this form. Instead, you must do an Originating Application (Form F4.03A). Completing Your Joint Originating Application You can fill out this form by hand or you can download and fill out this form electronically at www.court.nl.ca/supreme/family/forms.html (If you fill out the form electronically, you must still print the form and file it with the Court). You must fill out all of the pages in this Joint Originating Application and attach an agreement or a Consent Order (Form F34.02A and/or F34.02B). If you need more space to fill out any

section of this Joint Originating Application, attach an extra page and indicate which

section is continued on the extra page. Filing Your Joint Originating Application You must make 2 extra copies of your completed and signed Joint Originating Application (including any attachments). File your original Joint Originating Application with the Court. To file your Joint Originating Application, you can either bring it to a Supreme Court location near you or you can mail it to a Supreme Court location near you.

Serving Your Joint Originating Application Since all of the Co-Applicants have signed the filed Joint Originating Application, you do NOT need to serve the Joint Originating Application on the other Co-Applicant(s). However, you should still make sure all the Co-Applicants have a copy of the Joint Originating Application and all attachments. More Information Questions? Go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding or getting a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 644 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 1 Form F4.04A: Joint Originating Application (Family Law) In the Supreme Court of Newfoundland and Labrador Trial Division (General/Family) FOR COURT USE ONLY COURT FILE NO: CENTRAL DIVORCE REGISTRY NO: Filed at _____________________________ , Newfoundland and Labrador, this ________ day of __________________, 20______.

Registry Clerk of the Supreme Court of Newfoundland and Labrador BETWEEN: CO-APPLICANT (Print full name) AND: CO-APPLICANT (Print full name) AND: NOT APPLICABLE CO-APPLICANT(Print full name) You must start your application at the Court location that is closest to you or closest to the other party. However, if your family law matter involves parenting or child support, you must start your application at the Court location that is closest to where your children live.

Anthony (Corner Brook Circuit) Corner Brook Supreme Court (Family Division) St. John’s St. John’s Supreme Court (Family Division) Stephenville (Corner Brook Circuit) Corner Brook Supreme Court (Family Division) Wabush (Happy Valley – Goose Bay Circuit) Happy Valley – Goose Bay Supreme Court 645 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 2 Check the type of order(

s) that you are seeking: You must fill out and file the Schedule(

s) and any additional documents that relate to your claim(s). Type of Order Fill Out

Schedule Attachment(s) Divorce 1 Original marriage certificate Parenting (Decision-making and parenting time) 2 Consent Order or agreement Child Support 3 Consent Order or agreement Spousal (married) Support or Partner (unmarried) Support 4 Consent Order or agreement Parental Support (for parents) or Dependant Support (for spouse or child of deceased person) 4 Consent Order or agreement Division of Matrimonial (married) Property, Common Law (unmarried) Property, or Property under the FHRMIR Act 5 Consent Order or agreement Other: ___________________________________ 6 Consent Order or agreement Fill in the information below for the first Co-Applicant: Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Please note that if you provide your email address, the Court may contact you by email.

Date of Birth Month: Day: Year: Occupation(

s) or Job(

s) Citizen / Immigration Status Canadian Citizen Permanent Resident Foreign National Are you a registered Indian under the Indian Act? Yes No If yes, what is the name of your band? Do you live on a reserve? Do you need an interpreter? Yes No Please note that the Court is not responsible for any interpreter fees or arrangements. If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) 646 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 3 Fill in the information below for the second Co-Applicant: Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Date of Birth Month: Day: Year: Occupation(

s) or Job(

If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) Fill in the information about your relationship below: Relationship of the parties Date the parties started living together Month: Day: Year: OR Not applicable Date of marriage Month: Day: Year: OR Not applicable Place of marriage OR Not applicable Prior to the marriage, the first Co-Applicant was Unmarried Divorced Widowed OR Not applicable Prior to the marriage, the second Co-Applicant was Unmarried Divorced Widowed OR Not applicable Date of separation Month: Day: Year: OR Not applicable Date of divorce Month: Day: Year: OR Not applicable Check this box if there are more than 2 Co-Applicants.

Attach an extra page to provide the information of the other Co-Applicant(

s) and details of your relationship with the other Co-Applicant(s). 647 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 4 Fill in the information for every child of your relationship (Include children under and over 19 and non-dependent children): Child 1 Child 2 Child’s Full Name Mother’s Full Name Father’s Full Name Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs Child 3 Child 4 Child’s Full Name Mother’s Full Name Father’s Full Name Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs Check this box if there are no children.

Check this box if there are more than 4 children. Attach an extra page to provide the details of those children. If child protection services have ever been involved with you, the other Co-Applicant(s), and/or the children, provide the details below. Provide the details of any current or ongoing court proceedings, court orders, and/or written agreements involving you, the Respondent(s), and/or the children. Attach any written agreements and any court orders not in the Court file. 648 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 5 If there are more than 2 Co-Applicants, attach an extra page with the signatures required below. Statement of Truth All Co-Applicants must swear or affirm that the facts and information in this Application and the attached Consent Order(

s) is the truth. You must swear or affirm and sign this Statement of Truth in front of a commissioner of oaths, notary public, justice of the peace, or lawyer. Court Registry staff are commissioners of oaths and you may sign this application at the Court when you file it. First Co-Applicant Second Co-Applicant I declare the facts and information in this Joint Originating Application are true to the best of my knowledge and belief. I declare the facts and information in this Joint Originating Application are true to the best of my knowledge and belief.

SWORN TO or AFFIRMED at ___________________, this ________ day of _________________ , 20_____ . SWORN TO or AFFIRMED at ___________________, this ________ day of _________________ , 20_____ . Signature of First Co-Applicant Signature of Second Co-Applicant Commissioner of Oaths / Justice of the Peace Commissioner of Oaths / Justice of the Peace Lawyer’s Certificate If any of the Co-Applicants has a lawyer and you have applied for a divorce, your lawyer(

s) must complete this Certificate. If none of the Co-Applicants has a lawyer, you do not need to fill out this section. First Co-Applicant’s Lawyer (if any) Second Co-Applicant’s Lawyer (if any) I, ____________________________, the Lawyer for ____________________________, the Co-Applicant, certify that I have complied with the requirements of s.9 of the Divorce Act. I, ____________________________, the Lawyer for ____________________________, the Co-Applicant, certify that I have complied with the requirements of s.9 of the Divorce Act.

Dated at ___________________________________, this ________ day of _________________ , 20_____ . Dated at ___________________________________, this ________ day of _________________ , 20_____ . Signature of Lawyer Signature of Lawyer 649 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 6 (Note: This

Schedule is intended for divorce applications under the Divorce Act. If you are seeking a divorce under the Civil Marriages Act, fill out

Schedule 6.)

We are seeking a divorce because there has been a permanent breakdown in our marriage based upon separation: Check this box if the parties currently live separate and apart and will have lived separate and apart for at least 1 year prior to the determination of the divorce proceeding. If the parties have been living separate and apart for less than 1 year, you may still file an Application for divorce on the grou nd of separation. However, you must wait until 1 year has elapsed to file an Application for Judgment for divorce.

Check the box that applies to you and fill out any information needed: There are no children of the marriage OR Reasonable arrangements have been made for the support of the children (Give details and include your annual incomes): 650 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 7

Schedule 2 Parenting If you are making a joint application with respect to parenting (custody and/or access), fill in the information below: What are the current parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other contact (ie. phone or internet): Other important issues in relation to parenting the child(ren): 651 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 8 What are your proposed parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other contact (eg. phone, internet, etc.): Other important issues in relation to parenting the child(ren): 652 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 9

Schedule 3 Child Support Check all of the boxes that apply: We agree to the basic table amount as per the Child Support Guidelines. We agree on special and/or extraordinary expenses. We agree to an amount of child support that is different from the Child Support Guidelines basic table amount. What are your incomes? Co-Applicant 1’s Annual Income: $ Co-Applicant 2’s Annual Income: $ What are your reason(

s) for an amount of child support that is different from the Child Support Guidelines? We agree to child support in the amount of $ _____________________________ per month. Each of us has physical custody of (or exercise access to) the child(ren) for 40% or more of the year. The child(ren) is(are) 19 years of age or older. One or more of the persons who is obligated to pay support has an income that is more than $150,000 annually. One or more of us is claiming undue hardship for the following reason(s): Other: We agree to an amount of retroactive child support. Describe the reason(

s) for retroactive child support: 653 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 10

Schedule 4 Spousal, Partner, Parental, or Dependent Support Check all of the boxes that apply and fill in the information required: We have agreed to an amount of : Spousal support Partner support Parental support Dependent support Describe the reason(

s) for support: We have agreed to an amount of: Retroactive spousal support Retroactive partner support Retroactive parental support Retroactive dependent support Describe the reason(

s) for retroactive support: 654 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 11

Schedule 5 Division of Property Check all of the boxes that apply and fill in any information required: We agree to an equal division of matrimonial property. We agree to an unequal division of matrimonial property. Describe the reason(

s) for an unequal division of property: We agree to a division of common law property. Describe the property claim and the reason(

s) for the property claim: We agree to a division of property under the Family Homes on Reserves and Matrimonial Interests or Rights Act. Describe your property claim, the facts, and your reason(

s) for seeking the claim: Other: Describe the property claim and the reason(

s) for the property claim: 655 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 12

Schedule 6 Other Applications If you have come to an agreement on something other than the claims listed in the other Schedules, state what you are agreeing to and give reasons: 656 The Newfoundland and Labrador Gazette June 2, 2017

Withdrawal from Joint Originating Application (Family Law) - Instructions Supreme Court of Newfoundland and Labrador (Trial Divisio

n) Rules of the Supreme Court, 1986 (May 2017) Page 1 of 1 How to Withdraw a Joint Originating Application or Joint Originating Application for Variation Instructions A Withdrawal of Joint Originating Application (F4.04B) notifies the Court and the other person that you are withdrawing from your Joint Originating Application or Joint Originating Application for Variation.

Completing Your Withdrawal of Joint Originating Application You may fill out this form by hand or online: www.court.nl.ca/supreme/family/forms.html (If you fill out the form online, you must still print the form, file it, and serve it on the other person) Along with your Withdrawal, you must complete a Response (Form F6.02A) to respond to the family law issues that you disagree with or to make any new claims.

You can get a Response form at any Supreme Court location or online: www.court.nl.ca/supreme/family/forms.html Filing Your Withdrawal of Joint Originating Application You must file your Withdrawal of Joint Originating Application and Response at the same Court location where the Joint Originating Application or Joint Originating Application for Variation was filed. To file your documents with the Court, you can either bring it to the same Supreme Court location or you can mail it to same Supreme Court location. If you are mailing a document, be sure to attach the filing fee.

You can look up the fees online: www.court.nl.ca/supreme/fees.html You must make 2 extra copies of your completed and signed Withdrawal of Joint Originating Application and file your original Withdrawal of Joint Originating Application with the Court. You must make 3 extra copies of your completed and signed Response and file your Response with the Court. Your Response must be filed at the same time as your Withdrawal of Joint Originating Application.

Serving Your Withdrawal of Joint Originating Application You will need to give a copy of the Withdrawal of Joint Originating Application and your Response to the other person. This is called service. You can serve the other person by: personal service (an adult, who is not you, can hand-deliver the document), leaving a copy of the with the other person’s lawyer, leaving a copy at the other person’s address, registered mail/courier, or regular mail. You can also serve the other person using fax, email, or electronic document exchange, if the other person has provided that information.

If you are making claims for divorce or parenting, an adult (who is not you) must hand-deliver the Response to the other person (personal service). More Information Questions? Go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 --- REMOVE THIS PAGE BEFORE SERVING THE WITHDRAWAL --- 657 The Newfoundland and Labrador Gazette June 2, 2017

Form F4.04B – Withdrawal from Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division ) Rules of the Supreme Court, 1986 (May 2017) Page 1 Form F4.04B: Withdrawal of Joint Originating Application (Family Law) In the Supreme Court of Newfoundland and Labrador Trial Division (General/Family) FOR COURT USE ONLY COURT FILE NO: CENTRAL DIVORCE REGISTRY NO: Filed at _____________________________ , Newfoundland and Labrador, this ________ day of __________________, 20______.

Registry Clerk of the Supreme Court of Newfoundland and Labrador BETWEEN: CO-APPLICANT (Print full name) AND: CO-APPLICANT (Print full name) AND: NOT APPLICABLE CO-APPLICANT(Print full name) I, , the Co-Applicant, withdraw from the (Print your name) Joint Originating Application or Joint Originating Application for Variation, dated . (Date: month/day/year) DATED at _______________________, this _________ day of _________________ , 20_____ . Signature Signature of Lawyer (if any) 658 The Newfoundland and Labrador Gazette June 2, 2017

Originating Application for Variation – Instructions for the Applicant Supreme Court of Newfoundland and Labrador (Trial Division) Rules of Supreme Court, 1986 (May 2017) Page 1 of 1 How to Make an Originating Application for Variation Instructions for the Applicant You may use an Originating Application for Variation (Form F5.05A) if you want to change a final family law order. If you start an Originating Application for Variation, you are the Applicant . The other person is the Respondent. If you are making an application together with the other person (i.e. a joint application), you cannot use this form.

You must make a Joint Originating Application for Variation (Form F5.06A). Completing Your Originating Application for Variation You can fill out this form by hand or you can download and fill out this form electronically at www.court.nl.ca/supreme/family/forms.html (If you fill out the form electronically, you must still print the form, file it with the Court, and serve a copy on the Respondent). You must fill out pages 1-5 of the Originating Application for Variation and attach any schedules and additional forms that apply to you. If you need more space to fill out any

section of this Originating Application for Variation, attach an extra page and indicate which

section is continued on the extra page. Filing Your Originating Application for Variation You must make 3 extra copies of your completed and signed Originating Application for Variation (including any attachments). File the original Originating Application for Variation with the Court. To file your Originating Application for Variation, you can either bring it to a Supreme Court location near you or you can mail it to a Supreme Court location near you (with the filing fee attached).

You can look up the fees online: www.court.nl.ca/supreme/fees.html Serving Your Originating Application for Variation Once you have filed your completed Originating Application for Variation with the Court, you must give a copy of the Application and the ‘Instructions for the Respondent’ page to the Respondent. This is called service. You have 180 days to serve the Respondent after you have filed the Application. If you do not serve the Application in 180 days, it will expire and you may have to file a new Application.

If your Application involves parenting, an adult (who is not you) must hand-deliver the Application to the Respondent. This is called personal service. If your Application does not involve parenting, you can serve the Respondent by leaving a copy with the Respondent’s lawyer, leaving a copy at the Respondent’s address, registered mail/courier, or regular mail. You may also serve the Respondent using fax, email, or electronic document exchange, if the Respondent has provided that information. You may have to file an Affidavit of Service (Form F8.11A) or Acknowledgement of Service (Form F8.04A) with the Court.

These forms are available online: www.court.nl.ca/supreme/family/forms.html More Information Questions? Go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 --- REMOVE THIS PAGE BEFORE SERVING THE APPLICATION --- 659 The Newfoundland and Labrador Gazette June 2, 2017

Originating Application for Variation – Instructions for the Respondent Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 1 of 1 How to Respond to an Originating Application for Variation Instructions for the Respondent A family law proceeding has been started against you. You are the Respondent in this proceeding. The person who has started this family law proceeding is the Applicant. Read the attached Originating Application for Variation (Form F5.05A) carefully. The Applicant has explained the family law issues that he/she would like to have resolved.

If you want to oppose any of the Applicant’s claims or if you want to make your own claims, you must file and serve a Response (Form F6.02A). You can find the Response form at any Supreme Court location or online: www.court.nl.ca/supreme/family/forms.html You have only 30 days after this Originating Application for Variation has been served on you to file and serve your Response (You have 60 days if you have been served outside of Canada or the United States). For more information on how to fill out, file, and serve a Response, read the “Instructions for the Respondent” page attached to the Response form.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 660 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 1 Form F5.05A: Originating Application for Variation (Family Law) In the Supreme Court of Newfoundland and Labrador Trial Division (General/Family) FOR COURT USE ONLY COURT FILE NO: CENTRAL DIVORCE REGISTRY NO: Filed at _____________________________ , Newfoundland and Labrador, this ________ day of __________________, 20______.

Anthony (Corner Brook Circuit) Corner Brook Supreme Court (Family Division) St. John’s St. John’s Supreme Court (Family Division) Stephenville (Corner Brook Circuit) Corner Brook Supreme Court (Family Division) Wabush (Happy Valley – Goose Bay Circuit) Happy Valley – Goose Bay Supreme Court 661 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 2 Check the type of order(

s) that you want to change: You must fill out the Schedule(

s) that relate to your claim(

s) and attach any additional forms or documents required. Type of Order Fill Out

Schedule Attach Parenting (Decision-making and parenting time) 1 - Child Support 2 Financial Statement (Form F10.02A) and/or income information, if applicable Spousal (married) Support or Partner (unmarried) Support 3 Financial Statement (Form F10.02A) Parental Support (for parents) or Dependant Support (for spouse or child of deceased person) 3 Financial Statement (Form F10.02A) Consent Order or Agreement 4 Signed consent order or agreement Other: ___________________________________ 4 - Fill in the details for the order that you are seeking to vary: Date Order was Issued Month: Day: Year: Which Court?

Place of Order City: Province: Country: Name of Justice or Judge Check this box if you have more than 1 order that you are seeking to change. Attach an extra page at the end of this application to provide the details of those orders. Applicant Information Fill in your information below: If you have safety concerns and do not want to provide your contact information, you may provide alternate contact information below. You must still provide the Court with your actual contact information in a sealed envelope. This envelope will not be available to the other party.

Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) 662 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 3 Email Address (if any) Date of Birth Month: Day: Year: Occupation(

s) or Job(

s) Citizen / Immigration Status Canadian Citizen Permanent Resident Foreign National Are you a registered Indian under the Indian Act? Yes No If yes, what is the name of your band: Do you live on a reserve? Does the Respondent need an interpreter? Yes No Please note that the Court is not responsible for any interpreter fees or arrangements.

s) or Job(

s) Citizen / Immigration Status Canadian Citizen Permanent Resident Foreign National Is the Respondent a registered Indian under the Indian Act? Yes No If yes, what is the name of the Respondent’s band? Does the Respondent live on a reserve? Does the Respondent need an interpreter? Yes No Please note that the Court is not responsible for any interpreter fees or arrangements. If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) 663 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 4 Fill in the information about your relationship with the Respondent: Your relationship with the Respondent Date the parties started living together Month: Day: Year: OR Not applicable Date of marriage Month: Day: Year: OR Not applicable Place of marriage OR Not applicable Prior to the marriage, I was Unmarried Divorced Widowed OR Not applicable Prior to the marriage, the Respondent was Unmarried Divorced Widowed OR Not applicable Date of separation Month: Day: Year: OR Not applicable Date of divorce Month: Day: Year: OR Not applicable Check this box if you are starting a proceeding against more than one Respondent.

Attach an extra page to this Application to provide the information of the other Respondent(

s) and the details of your relationship with the other Respondent(s). If child protection services have ever been involved with you, the Respondent(s), and/or the children, provide the details below. Provide the details of any current or ongoing court proceedings, court orders, and/or written agreements involving you, the Respondent(s), and/or the children. Attach any written agreements and any court orders not in the Court file.

Fill in the information for every child of your relationship (Include children under and over 19 and non-dependent children): Child 1 Child 2 Child’s Full Name Mother’s Full Name Father’s Full Name Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs 664 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 5 Child 3 Child 4 Child’s Full Name Mother’s Full Name Father’s Full Name Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs Check this box if there are more than 4 children. Attach an extra page to provide the details of those children. Statement of Truth You must swear or affirm that the facts and information you have written in this Application and the attached Schedule(

s) is the truth. You must swear or affirm and sign this Statement of Truth in front of a commissioner of oaths, notary public, justice of the peace, or lawyer. You may also do this at the court registry. I declare that the facts and information in this Originating Application for Variation are true to the best of my knowledge and belief. SWORN TO or AFFIRMED at _______________________, this _________ day of _________________ , 20_____ .

Signature of Applicant Signature of Person Authorized to Administer Oaths Lawyer’s Signature for Fee Waiver I am employed by the Newfoundland and Labrador Legal Aid Commission or a Newfoundland and Labrador government department under the Executive Council Act and I am the lawyer of record in this matter. Signature of Lawyer (if any) Print Name of Lawyer (if any) 665 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 6

Schedule 1 Parenting Complete this

section if you are applying to change parenting arrangements (custody and/or access): Why are you asking to have the parenting order changed? Describe what has changed since the time the parenting order was made. What are the current parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other contact (eg. phone, internet, etc.): Other important issues in relation to parenting the child(ren): 666 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 7 What are your proposed parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other contact (eg. phone, internet, etc.): Other important issues in relation to parenting the child(ren): 667 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 8

Schedule 2 Child Support Complete this

section if you are applying to change child support: What is your current child support arrangement? Are there arrears or unpaid support? Yes No If yes, attach the most current Support Enforcement (SED) statement and specify: Amount: $_________________________________________________________ As of (date) (month/day/year): _________________________________________ Is child support assigned to be paid to someone else? (eg.

Department of Advanced Education, Skills and Labour) Yes No If yes, provide the details of the assignment arrangement: Check all of the boxes that apply and fill in the information required: I am seeking a change in the Child Support Guidelines basic table amount of child support: For the following child(ren): Effective Date: Month: Day: Year: Describe the facts and your reason(

s) for seeking a change in the amount of child support: You must attach all of the financial documents required by page 4 of the Financial Statement (Form F10.02A). 668 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 9 I am seeking a change in child support to an amount that is different from the Child Support Guidelines basic table amount. For the following child(ren): Effective Date: Month: Day: Year: List your reason(

s) for seeking an amount of child support different from the Child Support Guidelines: Depending on your reasons for seeking an amount different from the Child Support Guidelines, you may have to file additional documentation. The Respondent and I have agreed to child support in the amount of $ ______________ per month. I have physical custody of (or exercise access to) the child(ren) for 40% or more of the year. You must complete and attach a Financial Statement (Form F10.02A). The child(ren) is(are) 19 years of age or older. You must complete and attach a Financial Statement (Form F10.02A).

One or more of the persons who is obligated to pay support has an income that is more than $150,000 annually. You must complete and attach a Financial Statement (Form F10.02A). I am claiming undue hardship for the following reason(s): You must complete and attach a Financial Statement (Form F10.02A). Other: Depending on your claim, you may be required to complete and attach a Financial Statement (Form F10.02A). I am seeking a change in the amount of special and/or extraordinary expenses.

You must complete and attach a Financial Statement (Form F10.02A).You must also provide the information below: For the following child(ren): Effective Date: Month: Day: Year: Describe the facts and your reason(

s) for seeking a change in the amount of special and/or extraordinary expenses: 669 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 10 I am seeking retroactive child support. For the following child(ren): Effective Date: Month: Day: Year: What is the amount of retroactive child support that you are seeking? $_______________________________ Describe the facts and your reason(

s) for seeking retroactive child support: I am seeking a termination of child support. For the following child(ren): Effective Date: Month: Day: Year: List your reason(

s) for terminating child support: I am seeking child support because a change in our parenting arrangement(

s) has given rise to child support and there is no child support order currently in place. You must file and complete

Schedule 1 – Parenting of this form. If you are seeking an amount different from the Child Support Guidelines basic table amount, you must also complete and attach a Financial Statement (Form F10.02A). For the following child(ren): Effective Date: Month: Day: Year: What is the amount of child support that you are seeking? $________________________________________ Describe your claim, the facts, and your reason(

s) for seeking support: 670 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 11 Other changes to child support: For the following child(ren): Effective Date: Month: Day: Year: What is the amount of child support that you are seeking? $________________________________________ Describe your claim, the facts, and your reason(

s) for seeking a change in support: 671 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 12

Schedule 3 Spousal, Partner, Parental, or Dependant Support If you are seeking a change in spousal, partner, parental or dependant support, you must complete and attach a Financial Statement (Form F10.02A) If you are applying to change spousal, partner, parental, and/or dependant support, fill in the information below: What is your current spousal, partner, parental, and/or dependant support arrangement? Are there arrears or unpaid support?

Yes No If yes, attach the most current Support Enforcement (SED) statement and specify: Amount: $_________________________________________________________ As of (date) (month/day/year): _________________________________________ Is support assigned to be paid to someone else? (eg. Department of Advanced Education, Skills and Labour) Yes No If yes, provide the details of the assignment arrangement: Check all of the boxes that apply and fill in the information required: I am seeking a change in spousal, partner, parental, or dependant support.

For the following person(s): Effective Date: Month: Day: Year: Describe the facts and your reason(

s) for seeking a change in support: 672 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 13 I am seeking retroactive spousal, partner, parental, or dependant support. For the following person(s): Effective Date: Month: Day: Year: Describe the facts and your reason(

s) for seeking retroactive support: I am seeking a termination of spousal, partner, parental, or dependant support. For the following person(s): Effective Date: Month: Day: Year: Describe the facts and your reason(

s) for terminating support: Other change(

s) to spousal, partner, parental, or dependant support: For the following person(s): Effective Date: Month: Day: Year: Describe your claim, the facts, and your reason(

s) for seeking a change in support: 673 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.05A - Originating Application for Variation Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May2017) Page 14

Schedule 4 Other If you want to change a court order for something other than what is in the other Schedules, state what you are seeking, describe the facts, and give reasons: 674 The Newfoundland and Labrador Gazette June 2, 2017

Joint Originating Application for Variation (Family Law) – Instructions Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 1 of 1 How to Make a Joint Originating Application for Variation Instructions for Co-Applicants You may use a Joint Originating Application for Variation (Form F5.06A) if you and the other person(

s) would like to change a family law order together. You and the other person(

s) are Co-Applicants. If there are any issues that you do not agree on, you must use the general Originating Application for Variation (Form F5.05A). However, you can still do Consent Order(

s) on the issues you agree on. Completing Your Joint Originating Application for Variation You can fill out this form by hand or you can download and fill out this form electronically at www.court.nl.ca/supreme/family/forms.html (If you fill out the form electronically, you must still print the form and file it with the Court). You must fill out the entire Joint Originating Application for Variation and attach an agreement or a Consent Order (Form F34.02A and/or F34.02B). If you need more space to fill out any

section of this Joint Originating Application for Variation, attach an extra page and indicate which

section is continued on the extra page. Filing Your Joint Originating Application for Variation You must make 2 extra copies of your completed and signed Joint Originating Application for Variation (including any additional documentation). File your original Joint Originating Application for Variation with the Court. To file your Joint Originating Application for Variation, you can either bring it to a Supreme Court location near you or you can mail it to a Supreme Court location near you.

Serving Your Joint Originating Application for Variation Since all of the Co-Applicants have signed the Joint Originating Application for Variation, it does NOT need to be served on the other Co-Applicant(s). However, you should still make sure all of the Co-Applicants have a copy of the Joint Originating Application for Variation and all attachments. More Information Questions? Go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 675 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 1 Form F5.06A: Joint Originating Application for Variation (Family Law) In the Supreme Court of Newfoundland and Labrador Trial Division (General/Family) FOR COURT USE ONLY COURT FILE NO: CENTRAL DIVORCE REGISTRY NO: Filed at _____________________________ , Newfoundland and Labrador, this ________ day of __________________, 20______.

Anthony (Corner Brook Circuit) Corner Brook Supreme Court (Family Division) St. John’s St. John’s Supreme Court (Family Division) Stephenville (Corner Brook Circuit) Corner Brook Supreme Court (Family Division) Wabush (Happy Valley – Goose Bay Circuit) Happy Valley – Goose Bay Supreme Court 676 The Newfoundland and Labrador Gazette June 2, 2017

s) that you are seeking: You must fill out and file the Schedule(s), and any additional Form(

s) that relate to your claim(s). Type of Order Fill Out

Schedule Fill Out Form(

s) or Attach Document(s) Parenting (Decision-making and parenting time) 1 Consent Order or Agreement Child Support 2 Consent Order or Agreement Spousal (married) Support or Partner (unmarried) Support 3 Consent Order or Agreement Parental Support (for parents) or Dependant Support (for spouse or child of deceased person) 3 Consent Order or Agreement Other: ___________________________________ 4 Consent Order or Agreement Fill in the details for the order that you are seeking to vary: Date Order was Issued Month: Day: Year: Which Court?

Fill in the information below for the first Co-Applicant: Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Date of Birth Month: Day: Year: 677 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 3 Occupation(

s) or Job(

If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) Fill in the information below for the second Co-Applicant: Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Date of Birth Month: Day: Year: Occupation(

s) or Job(

s) Citizen / Immigration Status Canadian Citizen Permanent Resident Foreign National Are you a registered Indian under the Indian Act? Yes No If yes, what is the name of your band? Do you live on a reserve? Does the Respondent need an interpreter? Yes No Please note that the Court is not responsible for any interpreter fees or arrangements. If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) 678 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 4 Fill in the information about your relationship below: Relationship of the parties Date the parties started living together Month: Day: Year: OR Not applicable Date of marriage Month: Day: Year: OR Not applicable Place of marriage OR Not applicable Prior to the marriage, the first Co-Applicant was Unmarried Divorced Widowed OR Not applicable Prior to the marriage, the second Co-Applicant was Unmarried Divorced Widowed OR Not applicable Date of separation Month: Day: Year: OR Not applicable Date of divorce Month: Day: Year: OR Not applicable Check this box if there are more than 2 Co-Applicants.

Attach an extra page to provide the information of the other Co-Applicant(

s) and details of your relationship with the other Co-Applicant(s). Fill in the information for every child of your relationship (Include children under and over 19 and non-dependent children): Child 1 Child 2 Child’s Full Name Mother’s Full Name Father’s Full Name Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs Child 3 Child 4 Child’s Full Name Mother’s Full Name Father’s Full Name Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs Check this box if there are no children.

Check this box if there are more than 4 children. Attach an extra page to provide the details of those children. 679 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 5 If child protection services have ever been involved with you, the other Co-Applicant(s), and/or the children, provide the details below. Provide the details of any current or ongoing court proceedings, court orders, and/or written agreements involving you, the Respondent(s), and/or the children. Attach any written agreements and any court orders not in the Court file.

If there are more than 2 Co-Applicants, attach an extra page with the signatures required below. Statement of Truth All Co-Applicants must swear or affirm that the facts and information in this Application and the attached Consent Order is the truth. You must swear or affirm and sign this Statement of Truth in front of a commissioner of oaths, notary public, justice of the peace, or lawyer. Court Registry staff are commissioners of oaths and you may sign this application at the Court when you file it.

First Co-Applicant Second Co-Applicant I declare the facts and information in this Joint Originating Application for Variation are true to the best of my knowledge and belief. I declare the facts and information in this Joint Originating Application for Variation are true to the best of my knowledge and belief. SWORN TO or AFFIRMED at ___________________, this ________ day of _________________ , 20_____ . SWORN TO or AFFIRMED at ___________________, this ________ day of _________________ , 20_____ .

Signature of First Co-Applicant Signature of Second Co-Applicant Signature of Person Authorized to Administer Oaths Signature of Person Authorized to Administer Oaths 680 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 6

Schedule 1 Parenting Complete this

section if you have agreed to change parenting arrangements (custody and/or access): Why are you asking to have the parenting order changed? (Describe what has changed since the time the parenting order was made) What are the current parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other contact (eg. phone, internet, etc.): Other important issues in relation to parenting the child(ren): 681 The Newfoundland and Labrador Gazette June 2, 2017

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other contact (eg. phone, internet, etc.): Other important issues in relation to parenting the child(ren): 682 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 8

Schedule 2 Child Support Complete this

section if you have agreed to change child support: Fill in the information below: What is your current child support arrangement? Are there arrears or unpaid support? Yes No If yes, attach the most current Support Enforcement (SED) statement and specify: Amount: $_________________________________________________________ As of (date) (month/day/year): _________________________________________ Is child support assigned to be paid to someone else? (eg.

Department of Advanced Education, Skills, and Labour) Yes No If yes, provide the details of the assignment arrangement: Check all of the boxes that apply and fill in the information required: We agree to calculate child support using the Child Support Guidelines basic table amount but agree to change the amount: For the following child(ren): Effective Date: Month: Day: Year: Describe the reason(

s) for changing the amount of child support: 683 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 9 We agree to change child support to an amount that is different from the Child Support Guidelines basic table amount. For the following child(ren): Effective Date: Month: Day: Year: What are your incomes? Co-Applicant 1’s Annual Income: $ Co-Applicant 2’s Annual Income: $ Check off the reason(

s) for changing the amount of child support to an amount different from the Child Support Guidelines: Both Co-Applicants must each file an Affidavit regarding your incomes and your ability to support your children. We agree to child support in the amount of $ ______________ per month. Each of us has physical custody of (or exercise access to) the child(ren) for 40% or more of the year. The child(ren) is(are) 19 years of age or older. One or more of the persons who is obligated to pay support has an income that is more than $150,000 annually.

One or more of us is claiming undue hardship for the following reason(s): Other: We agree to change the amount of special and/or extraordinary expenses. For the following child(ren): Effective Date: Month: Day: Year: Describe the reason(

s) for changing the amount of special and/or extraordinary expenses: 684 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 10 We agree to an amount of retroactive child support. For the following child(ren): Effective Date: Month: Day: Year: What amount of retroactive child support do you agree to? $_______________________________ Describe the reason(

s) for retroactive child support: We agree to terminate child support. For the following child(ren): Effective Date: Month: Day: Year: Describe the reason(

s) for terminating child support: We agree to other changes to child support: For the following child(ren): Effective Date: Month: Day: Year: What amount of child support do you agree to? $________________________________________ Describe the reason(

s) for changing support: 685 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 11

Schedule 3 Spousal, Partner, Parental, or Dependent Support If you are applying to change spousal, partner, parental, and/or dependent support, fill in the information below: What is your current spousal, partner, parental, and/or dependent support arrangement? Are there arrears or unpaid support? Yes No If yes, attach the most current Support Enforcement (SED) statement and specify: Amount: $_______________________________________________ As of (date) (month/day/year): _______________________________ Is support assigned to be paid to someone else? (eg.

Department of Advanced Education, Skills and Labour) Yes No If yes, provide the details of the assignment arrangement (to the best of your knowledge): Check all of the boxes that apply and fill in the information required: We agree to change spousal, partner, parental, or dependent support. For the following person(s): Effective Date: Month: Day: Year: Describe the facts and your reason(

s) for seeking a change in support: 686 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 12 We agree to change retroactive spousal, partner, parental, or dependent support. For the following person(s): Effective Date: Month: Day: Year: Describe the facts and your reason(

s) for seeking retroactive support: We agree to terminate spousal, partner, parental, or dependent support. For the following person(s): Effective Date: Month: Day: Year: Describe the facts and your reason(

s) for terminating support: We agree to other change(

s) to spousal, partner, parental, or dependent support: For the following person(s): Effective Date: Month: Day: Year: Describe your claim, the facts, and your reason(

s) for seeking a change in support: 687 The Newfoundland and Labrador Gazette June 2, 2017

Form F5.06A – Joint Originating Application for Variation (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 13

Schedule 4 Other If you are seeking a change for something other than the claims requested in the Schedules, state what you are seeking and give reasons: 688 The Newfoundland and Labrador Gazette June 2, 2017

Response (Family Law) – Instructions for the Respondent Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 1 of 1 How to Respond to an Originating Application or Originating Application for Variation Instructions for the Respondent If you have been served with an Origination Application or an Originating Application for Variation, you are the Respondent in a family law court proceeding. The person who has started this proceeding is the Applicant.A Response (Form F6.02A) is a form you use to respond to an Application.

In the Response, you set out what your position is on the family law issues. You may also make your own claims in your Response. If you do not respond, the Court may proceed and make an order without hearing from you. Completing Your Response You can fill out this form by hand or you can download and fill out this form electronically at www.court.nl.ca/supreme/family/forms.html (If you fill out the form electronically, you must still print the form, file it with the Court, and serve a copy on the Applicant).

You must fill out pages 1-4 of the Response and attach any schedules and additional forms that apply to you. If you need more space to fill out any

section of this Response, attach an extra page. If you are Responding to a claim for basic table amount of child support, you must attach all of the financial documents set out on page 4 of the Financial Statement (Form F10.02A). Filing Your Response You must make 3 extra copies of your completed and signed Response (including any additional documentation). File your original Response with the Court. To file your Response, you can either bring it to a Supreme Court location near you or you can mail it to a Supreme Court location near you (with the filing fee attached).

You can look up the fees online:www.court.nl.ca/supreme/fees.html. You have only 30 days after the Application has been served on you to file your Response (You have 60 days if you have been served outside of Canada or the United States). Serving Your Response You must give a copy of the Response to the Applicant. This is called service. You have only 30 days after the Application has been served on you to serve your Response (You have 60 days if you have been served outside of Canada or the United States).

If you are making a new claim for parenting or divorce in your Response, an adult (who is not you) must hand-deliver the Response to the Applicant. This is called personal service. If you are not making a new claim for parenting or divorce, you may also serve the Applicant by personal service or by leaving a copy with the Applicant’s lawyer, leaving a copy at the Applicant’s address, registered mail/courier, or regular mail. You may also serve the Applicant using fax, email, or electronic document exchange, if the Applicant has provided that information.

You may have to file an Affidavit of Service (Form F8.11A) or Acknowledgement of Service (Form F8.04A) with the Court. These forms are available online: www.court.nl.ca/supreme/family/forms.html More Information Questions? Go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 --- REMOVE THIS PAGE BEFORE SERVING THE RESPONSE --- 689 The Newfoundland and Labrador Gazette June 2, 2017

Response (Family Law) – Instructions for the Applicant Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 1 of 1 How to Reply to a Response Instructions for the Applicant Read the attached Response (Form F6.02A) carefully. The Respondent has responded to the issues that you raised in your Originating Application or Originating Application for Variation. The Respondent may have also made some new claims in his/her Response. If you want to respond to any of these new claims, you must file and serve a Reply (Form F7.02A).

You can find the Response form at any Supreme Court location or online: www.court.nl.ca/supreme/family/forms.html You have only 10 days after this Response has been served on you to file and serve your Reply. If you do not reply, the Court may proceed and make an order without hearing from you. For more information on how to fill out, file, and serve a Reply, read the “Instructions for the Applicant” page attached to the Reply form. More Information Questions?

You can go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St. John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 690 The Newfoundland and Labrador Gazette June 2, 2017

Form F6.02A – Response (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 1 Form F6.02A: Response (Family Law) In the Supreme Court of Newfoundland and Labrador Trial Division (General/Family) FOR COURT USE ONLY COURT FILE NO: CENTRAL DIVORCE REGISTRY NO: Filed at _____________________________ , Newfoundland and Labrador, this ________ day of __________________, 20______.

Registry Clerk of the Supreme Court of Newfoundland and Labrador BETWEEN: APPLICANT (Print full name) AND: RESPONDENT (Print full name) AND: NOT APPLICABLE SECOND APPLICANT SECOND RESPONDENT (Print full name) Check all of the boxes that apply: I do not contest any of the claims made by the Applicant. I disagree with some or all of the claims made by the Applicant. Which claim(

s) do you agree with? It is helpful to indicate the page and

section of the Applicant’s application that you agree with. 691 The Newfoundland and Labrador Gazette June 2, 2017

Form F6.02A – Response (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 2 Which claim(

s) do you disagree with? Explain why you disagree. It is helpful to indicate the page or

section of the Application that you disagree with. I am making my own claims. Only check this box if you are making new claims that were not addressed in the Originating Application or Originating Application for Variation. You must fill out and file the Schedule(

s) and any additional Form(

s) that correspond with your claim(s). I am seeking: Type of Order Fill Out

Schedule Attach Divorce 1 Original marriage certificate Parenting (Custody / Access) 2 - Child Support 3 Financial Statement (Form F10.02A) if applicable Spousal (married) Support or Partner (unmarried) Support 4 Financial Statement (Form F10.02A) Parental Support (for parents) or Dependant Support (for spouse or child of deceased person) 4 Financial Statement (Form F10.02A) Division of Matrimonial (married) Property or Common Law (unmarried) Property 5 Property Statement (Form F10.02A) Return of Child (within Canada) 6 Emergency Temporary Relief Application (Form 17.03A) if applicable Consent Order 7 Consent Order (Form F34.02A and/or F34.02B) Other: ______________________________ 7 - 692 The Newfoundland and Labrador Gazette June 2, 2017

Form F6.02A – Response (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 3 Respondent Information Fill in your information below: If you have safety concerns and do not want to provide your contact information, you may provide alternate contact information below. You must still provide the Court with your actual contact information in a sealed envelope. This envelope will not be available to the other party.

Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Date of Birth Month: Day: Year: Occupation(

s) or Job(

s) Citizen / Immigration Status Canadian Citizen Permanent Resident Foreign National Are you a registered Indian under the Indian Act? Yes No If yes, what is the name of your band? Do you live on a reserve? Do you need an interpreter? Yes No Please note that the Court is not responsible for any interpreter fees or arrangements. If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) Check this box if there is more than 1 Respondent. Attach an extra page to provide the information of the other Respondent(s).

Fill in the information about your relationship with the Applicant Your relationship with the Applicant Date the parties started living together Month: Day: Year: OR Not applicable Date of marriage Month: Day: Year: OR Not applicable Place of marriage OR Not applicable Prior to the marriage, you were Unmarried Divorced Widowed OR Not applicable Prior to the marriage, the Applicant was Unmarried Divorced Widowed OR Not applicable Date of separation Month: Day: Year: OR Not applicable Date of divorce Month: Day: Year: OR Not applicable 693 The Newfoundland and Labrador Gazette June 2, 2017

Form F6.02A – Response (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 4 If child protection services have ever been involved with you, the Applicant, and/or the children, provide the details: Provide the details of any current or ongoing court proceedings, court orders, and/or written agreements involving you, the Applicant, and/or the children. Attach any written agreements and any court orders not in the Court file. Statement of Truth You must swear or affirm that the facts and information that you have written in this Response and the attached Schedule(

s) is the truth. You must swear or affirm and sign this Statement of Truth in front of a commissioner of oaths, notary public, justice of the peace, or lawyer. Court Registry staff are commissioners of oaths and you may sign this Response at the Court when you file it. If there is more than 1 Respondent, attach an extra page with the signatures required below. I declare the facts and information in this Response are true to the best of my knowledge and belief. SWORN TO or AFFIRMED at _______________________, this _________ day of _________________ , 20_____ .

Signature of Respondent Signature of Person Authorized to Administer Oaths Lawyer’s Signature for Fee Waiver I am employed by the Newfoundland and Labrador Legal Aid Commission or a Newfoundland and Labrador government department under the Executive Council Act and I am the lawyer of record in this matter. Signature of Lawyer (if any) Print Name of Lawyer (if any) Lawyer’s Certificate Check this box if you have a lawyer and are applying for divorce. Your lawyer must complete this Certificate. If you are not applying for divorce or do not have a lawyer, you do not have to fill out this Certificate.

I, ____________________________________ , the Lawyer for ______________________________________ , (Print Lawyer’s Name) (Print Respondent’s Name) the Respondent, certify to this Court that I have complied with the requirements of s.9 of the Divorce Act. Dated at _______________________, this _________ day of _________________ , 20_____ . Signature of Lawyer Address of Lawyer 694 The Newfoundland and Labrador Gazette June 2, 2017

Form F6.02A – Response (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 5 (Note: This

Schedule is intended for divorce applications under the Divorce Act. If you are seeking a divorce under the Civil Marriages Act, fill out

Schedule 7.)

I am seeking a divorce because there has been a permanent breakdown in our marriage based upon: Separation: Check this box if you and your spouse currently live separate and apart and will have lived separate and apart for at least 1 year prior to the determination of the divorce proceeding. If you and your spouse have been living separate and apart for less than 1 year, you may still claim a divorce on the ground of separation. However, you must wait until 1 year has elapsed to file an Application for Judgment for divorce.

Adultery: Check this box if you are seeking divorce because the Applicant has committed adultery. Attach an extra page with details of the adultery. You may be required to present further evidence of the adultery. You do not need to name any other person involved. If you choose to name another person, you must serve this Response on that person by personal service. That other person(

s) will have the same rights as a Respondent in relation to the adultery claim and may file a Response. Check this box to declare that you have not condoned or connived in the adultery. Cruelty: Check this box if you are seeking divorce because your spouse has treated you with physical or mental cruelty that makes continued cohabitation intolerable. Attach an extra page with details of the cruelty. You may be required to present further evidence of the physical or mental cruelty. Check this box to declare that you have not condoned or connived in the cruelty. 695 The Newfoundland and Labrador Gazette June 2, 2017

Form F6.02A – Response (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 6

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other contact (ie. phone or internet): Other important issues in relation to parenting the child(ren): 696 The Newfoundland and Labrador Gazette June 2, 2017

Form F6.02A – Response (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 7 What are your proposed parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other contact (eg. phone, internet, etc.): Other important issues in relation to parenting the child(ren): 697 The Newfoundland and Labrador Gazette June 2, 2017

Form F6.02A – Response (Family Law) Supreme Court of Newfoundland and Labrador (Trial Division) Rules of the Supreme Court, 1986 (May 2017) Page 8

s) for seeking an amount different from the Child Support Guidelines, you may have to attach further documentation. List your reason(

Document details

Collection	Newfoundland and Labrador — Gazette
Citation	NLG 2017-06-02
Type	gazette
Volume / chapter	printer gazette weekly issues 2017 nlg170602
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	a47bdec381ca29f06df61a1cde70af1a5987bdad

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