1. No category

C100
Application under the Children
Act 1989 for a child arrangements,
prohibited steps, specific issue
section 8 order or to vary or
discharge a section 8 order
To be completed by the court
Name of court
Date issued
Case number
Fee charged/Remission ID
Summary of application
Full name of applicant
Full name of respondent(s)
Some people need permission to apply See Section C of the leaflet CB1 for details on who needs permission and how to get permission.
If you are applying for an order by consent, Sections 12 to 15 on mediation and MIAMs should not be
completed.
Other information for the court (tick if relevant)
I am applying for
Child Arrangements Order - where the child(ren) will live
Child Arrangements Order - who the child(ren)
spend time with
The application is urgent, please give reasons in
Section 3b on page 5
The application is to be made without notice to
another party, please give reasons in Section 3c on
page 5
Prohibited Steps Order
Specific Issue Order
The application is for an order to formalise an agreement (consent order) which is attached to this form
Are you aware of any other current or
previous court cases concerning the
child(ren) listed over the page?
Name of the court where
proceedings heard
Yes
No
Case no.
Date/year (if known)
C100 Application under the Children Act 1989 for a child arrangements, prohibited steps, specific issue section 8 order or
to vary or discharge a section 8 order (04.14)
C100_0414_4.indd 1
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Please list the name(s) of the child(ren) and the type(s) of order you are applying for, starting with the oldest. To
understand which order to apply for read the booklet CB1 Section D.
Child 1 - Full name of child
Date of birth
D
D
/
M M
Gender
/
Y
Y
Y
Male
Y
Female
Not Known
Relationship to applicant(s)
Child 2 - Full name of child
Relationship to respondent(s)
Date of birth
D
D
/
M M
Gender
/
Y
Y
Y
Relationship to applicant(s)
Female
Relationship to respondent(s)
Date of birth
D
D
/
M M
Gender
/
Y
Y
Y
Relationship to applicant(s)
Female
Relationship to respondent(s)
Date of birth
D
D
/
M M
Gender
/
Y
Y
Y
Y
Not Known
Relationship to applicant(s)
Order(s) applied for
Male
Y
Not Known
Child 4 - Full name of child
Order(s) applied for
Male
Y
Not Known
Child 3 - Full name of child
Order(s) applied for
Order(s) applied for
Male
Female
Relationship to respondent(s)
Before completing this form please read the leaflet ‘CB1 – Making an application – Children and the Family Courts’
and the leaflet CB7 - Guide for separated parents: children and the family courts. You can get a copies of these your
local court or at www.justice.gov.uk. Please also read the information notes and complete the checklist at the end of
the form.
t 'BJMVSFUPDPNQMFUFFWFSZRVFTUJPOPSTUBUFJGJUEPFTOPUBQQMZDPVMEEFMBZUIFDBTFBTUIFDPVSUXJMMIBWFUP
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t *GUIFSFJTOPUFOPVHITQBDFQMFBTFBUUBDITFQBSBUFTIFFUTDMFBSMZTIPXJOHUIFEFUBJMTPGUIFDIJMESFOQBSUJFT
RVFTUJPOBOEQBHFOVNCFSUIFZSFGFSUP
t $BGDBTT$"'$"44$:.36XJMMDBSSZPVUDIFDLTBTJUDPOTJEFSTOFDFTTBSZ4FF4FDUJPO+PGMFBøFU$#GPSNPSF
JOGPSNBUJPOBCPVU$BGDBTTBOE$"'$"44$:.36
2
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3FRVJSFNFOUUPBUUFOEB.FEJBUJPO*OGPSNBUJPOBOE"TTFTTNFOU.FFUJOH.*".
Before making an application for a child arrangements order, prohibited steps order or specific issue order (a section
8 order) you must first attend a Mediation Information and Assessment Meeting (MIAM). At the MIAM an authorised
family mediator will consider with you (and the other party if present) whether family mediation, or another form of
non-court dispute resolution, would be a more appropriate alternative to court.
You must have attended a MIAM before making this application unlessUIFSFRVJSFNFOUUPBUUFOEB.*".EPFTOPU
apply because the section 8 order you are applying for:
t JTGPSBDPOTFOUPSEFSPS
t DPODFSOTBDIJMEXIPJTUIFTVCKFDUPGTFQBSBUFPOHPJOHFNFSHFODZQSPDFFEJOHTDBSFQSPDFFEJOHTPS
TVQFSWJTJPOQSPDFFEJOHTPSJTBMSFBEZUIFTVCKFDUPGBOFNFSHFODZDBSFPSTVQFSWJTJPOPSEFS
PS
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certified by a family mediator).
All applicants must complete sections 1 to 11 and complete and sign section 16 of this form. In addition, you must
UJDLPOFPGUIFCPYFTCFMPXBOEFOTVSFUIBUZPVZPVSMFHBMBEWJTFSPSBGBNJMZNFEJBUPSDPNQMFUFTBOETJHOTUIF
relevant section(s) of this form as shown.
1a. If you ticked ‘Yes’ to the
RVFTUJPOPOQBHFBCPVU
current or previous court
cases, are/were any of
those cases about an
emergency protection, care
or supervision order?
1b."SFZPVDMBJNJOHFYFNQUJPO
GSPNUIFSFRVJSFNFOUUP
attend a MIAM?
Yes
If Yes, skip sections 12 to
15 but complete section 6a
to provide additional details.
No
If No, please answer question b.
Yes
If Yes, complete and sign
section 12 and complete 13.
No
If No, please answer question c.
1c. Has a family mediator
informed you that a
NFEJBUPSTFYFNQUJPO
applies, and you do not need
to attend a MIAM?
Yes
1d. Have you attended a MIAM?
Yes
If Yes, you must ensure
that the family mediator
completes and signs section 14.
No
If No, please answer question d.
If Yes, you must ensure that the family mediator
completes and signs section 15.
No
If No, you cannot make this application.
3
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2. The child(ren) - further details
2a. Are any of the children
known to the local authority
children’s services?
Yes
No
Don’t know
2b. Are any of the children the
subject of a child protection plan
Yes
No
Don’t know
2c. Do all the children share the
same parents?
Yes
No
If Yes please state which child
and the name of the Local
Authority and Social worker
(if known)
If Yes, what are the names of the
parents?
If No, please give details of
each parent and their children
involved in this application
Please state everyone who has
parental responsibility for each
child and how they have parental
responsibility (e.g. ‘child’s mother’,
‘child’s father and was married to
the mother when the child was
born’ etc.)
(See Section E of leaflet CB1 for
more information)
2d. Who do the children currently
live with?
Applicant(s)
Respondent(s)
Other
If other, please give the full
address of the child, the names
of any adults living with the
children and their relationship to
or involvement with the child.
If you do not wish this
information to be made known to
the Respondent, leave the details
blank and complete Confidential
contact details Form C8
4
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3. Why are you making this application?
Have you applied to the court for
permission to make this application?
3a. Please give brief details:
t BOZQSFWJPVTBHSFFNFOUTGPSNBM
or informal), and how they have
broken down
t ZPVSSFBTPOTGPSCSJOHJOH
this application to the court
(including any concerns about
your children)
Yes
1FSNJTTJPOOPUSFRVJSFE
Do not give a full statement, please provide a summary of any relevant grounds
and reasons. You may be asked to provide a full statement later.
t XIBUZPVXBOUUIFDPVSUUPEP
t SFBTPOTHJWFOCZUIF
respondent(s) for their actions in
relation to this application.
3b. If the application is urgent,
please give reasons why
3c. If the application is to be made
XJUIPVUOPUJDFQMFBTFFYQMBJO
why
5
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4. Agreements about who a child is to live with and/or spend time with and when
4a. Have you previously prepared a
Parenting Plan?
Yes
If No, you can download a copy from the website
www.cafcass.gov.uk/parentingplan
No
If Yes, please attach the plan to this application form
5. Risk
5a. Do you believe that the
child(ren) named at Section 1
IBWFFYQFSJFODFEPSBSFBUSJTLPG
FYQFSJFODJOHIBSNGSPNBOZPGUIF
following by any person who has
had contact with the child?
any form of domestic violence
Yes
No
child abduction
Yes
No
child abuse
Yes
No
drugs, alcohol or substance abuse
Yes
No
other safety or welfare concerns
Yes
No
If you answered Yes to any of the above, please complete form C1A
(Supplemental information form).
6. Other court cases which concern the child(ren) listed on page 1 - further details
6a. Did you provide details on page
1 of other court cases now, or at any
time in the past, that concern the
children listed on page 1?
Yes
If Yes, please attach a copy of any relevant order, and complete the
EFUBJMTPGUIF$BGDBTT$"'$"44$:.36PóDFSBOEDIJMETTPMJDJUPS
below. If you do not have a copy of the order please complete all
the additional details below.
No
If No, please go to Section 7
Additional details
Name of child(ren)
/BNFBOEPóDFJGLOPXO
PG
$BGDBTT$"'$"44$:.36PóDFS
Please tick if additional
sheets are attached.
6
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7. Attending the court
Section N of the the booklet ‘CB1 - Making an application - Children and the Family Courts’ and the leaflet ‘CB7 Guide for separated parents: children and the family courts’ provide information about attending court.
If you require an interpreter, you must tell the court now so that one can be arranged.
7a. Do you or any of the parties
need an interpreter or other
assistance (e.g. sign lanuage signer)
at court?
Yes
No
If Yes, please specify the language and dialect:
7b. If attending the court, do you
Yes
No
or any of the parties involved have
BEJTBCJMJUZGPSXIJDIZPVSFRVJSF
special assistance or special facilities? If Yes, please say what the needs are
Please say whether the court needs
to make any special arrangements
for you to attend court (e.g.
providing you with a separate
waiting room from the respondent
or other security provisions).
$PVSUTUBòNBZHFUJOUPVDIXJUIZPVBCPVUUIFSFRVJSFNFOUT
7
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8. About you (the applicant(s))
Applicant 1 (You)
Applicant 2 (if applicable)
Full names
Previous names (if any)
Male
Gender
Date of birth (If under 18 read
section R of leaflet CB1)
D
D
/
M M
Female
/
Y
Y
Y
Male
Y
D
D
/
M M
Female
/
Y
Y
Y
Y
Place of birth
(town/county/country)
If you do not wish your address to be made known to the respondent, leave
the details below blank and complete Confidential contact details Form C8.
Address
Postcode
Postcode
Home telephone number
Mobile telephone number
Email address
Have you lived at this address for
more than 5 years?
Yes
No
Yes
No
If No, please provide details of all previous addresses you have lived at for the
last 5 years.
If you do not wish your contact
details to be made known to the
Respondent, leave the details
blank and complete Confidential
contact details Form C8
8
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9. The respondents
Sections G and H of the the booklet ‘CB1 - Making an application - Children and the Family Courts’FYQMBJOXIPB
respondent is.
If there are more than 2 respondents please continue on a separate sheet.
Respondent 1
Respondent 2
Full names
Previous names (if known)
Are they willing to attend a MIAM?
Yes
Gender
Date of birth (If party under 18
read section R of leaflet CB1)
No
Male
D
D
/
Yes
Female
M M
/
Y
Y
Male
Y
Not known
No
Y
D
D
/
Female
M M
/
Y
Y
Y
Y
Not known
Place of birth
(town/county/country)
Address (to which documents
relating to this application
should be sent)
Postcode
Postcode
Not known
Not known
Not known
Not known
Not known
Not known
Home telephone number
Mobile telephone number
Email address
continued over the page
9
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Have they lived at this address
for more than 5 years?
Yes
No
Don’t know
Yes
No
Don’t know
If No, please provide details of all previous addresses for the last 5 years below
(if known, including the dates and starting with the most recent)
10. Others who should be given notice
5IFSFNBZCFPUIFSQFPQMFXIPTIPVMECFOPUJöFEPGZPVSBQQMJDBUJPOGPSFYBNQMFTPNFPOFXIPDBSFTGPSUIF
child but is not a parent. Sections G and I of the the booklet ‘CB1 - Making an application - Children and the
Family Courts’FYQMBJOXIPPUIFSTBSF
Person1
Person 2
Full names
Previous names (if known)
Male
Gender
Date of birth
D
D
/
M M
Female
/
Y
Y
Y
Not known
Male
Y
D
D
/
M M
Female
/
Y
Y
Y
Y
Not known
Address
Postcode
Postcode
Not known
Not known
Please state their relationship to
the children listed on page 1. If
their relationship is not the same
to each child please state their
relationship to each child.
10
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11. Solicitors details
Do you have a solicitor acting
for you?
Yes
No
If No, see section R of leaflet CB1 for more information
If Yes, please give the following details
Your solicitor’s name
Name of firm
Address
Postcode
Telephone number
'BYOVNCFS
DX number
Solicitor’s Reference
Email address
11
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"QQMJDBOUDMBJNTFYFNQUJPOT
GSPNBUUFOEBODFBUB.FEJBUJPO*OGPSNBUJPOBOE
Assessment Meeting (MIAM)
The applicant has not attended a
MIAM because the following MIAM
FYFNQUJPOT
BQQMJFT
Domestic violence (see Section 13a)
Child protection concerns (see Section 13b)
6SHFODZTFFSection 13c)
1SFWJPVT.*".BUUFOEBODFPSQSFWJPVT.*".FYFNQUJPOTFFSection 13d)
Other (see Section 13e)
Signed
Applicant
Dated
D
D
/
M M
/
Y
Y
Y
Y
Signed
Legal representative (if relevant)
Name
Firm’s name
Address
Dated
D
D
/
M M
/
Y
Y
Y
Y
Now go to the relevant part of Section 13BTTIPXOBCPWFBOEUJDLUIFCPYT
under the relevant heading and provide further information where this is
asked for.
12
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'VSUIFSEFUBJMTPG.*".FYFNQUJPOT
DMBJNFECZUIFBQQMJDBOU
(To be completed by the person intending to make a court application or
their legal representative)
*GZPVIBWFDMBJNFEB.*".FYFNQUJPOJO4FDUJPOZPVNVTUBMTPUJDL
UIFSFMFWBOUCPYT
JOUIFSFMFWBOUQBSUPGUIJTTFDUJPOBTTIPXOCFMPXUP
confirm that you have the necessary evidence to support your ground(s) for
FYFNQUJPO8IFSFZPVBSFBTLFEUPQSPWJEFBEEJUJPOBMEFUBJMTZPVNVTUEPTP
Section 13a - Domestic violence evidence
The applicant confirms that there is evidence of domestic violence, as
specified below:
BSFMFWBOUVOTQFOUDPOWJDUJPOGPSBEPNFTUJDWJPMFODFPòFODF
a relevant police caution for a domestic violence offence given within
the twenty four month period immediately preceding the date of the
QSPTQFDUJWFBQQMJDBUJPO
evidence of relevant criminal proceedings for a domestic violence offence
XIJDIIBWFOPUDPODMVEFE
a relevant protective injunction which is in force or which was granted
within the twenty four month period immediately preceding the date of the
QSPTQFDUJWFBQQMJDBUJPO
an undertaking given in England and Wales under section 46 or 63E of the
1996 Act (or given in Scotland or Northern Ireland in place of a protection
injunction) —
J
CZBOZQSPTQFDUJWFQBSUZUPBOPUIFSQSPTQFDUJWFQBSUZBOE
(ii)
within the twenty four month period immediately preceding the
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a letter from the person appointed to chair a multi-agency risk assessment
conference confirming that —
(i)
any prospective party was referred to the conference as a high risk
WJDUJNPGEPNFTUJDWJPMFODFBOE
(ii)
the conference has, within the twenty four month period
immediately preceding the date of the prospective application, put
in place a plan to protect that party from a risk of harm by another
QSPTQFDUJWFQBSUZ
BDPQZPGBöOEJOHPGGBDUNBEFJOQSPDFFEJOHTJOUIF6OJUFE,JOHEPN
within the twenty four month period immediately preceding the date of the
prospective application, that there has been domestic violence giving rise to
BSJTLPGIBSNCZPOFQSPTQFDUJWFQBSUZUPBOPUIFSQSPTQFDUJWFQBSUZ
a letter or report from a health professional confirming that the
professional—
J
IBTFYBNJOFEBOZQSPTQFDUJWFQBSUZXJUIJOUIFUXFOUZGPVS
month period immediately preceding the date of the prospective
BQQMJDBUJPO
JJ
XBTTBUJTöFEGPMMPXJOHUIBUFYBNJOBUJPOUIBUUIBUQBSUZIBEJOKVSJFT
PSBDPOEJUJPODPOTJTUFOUXJUIUIPTFPGBWJDUJNPGEPNFTUJDWJPMFODF
and
(iii) has no reason to believe that that party’s injuries or condition were
OPUDBVTFECZEPNFTUJDWJPMFODF
13
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Section 13a - Domestic violence evidence (continued)
a letter from a social services department in England or Wales (or its
FRVJWBMFOUJO4DPUMBOEPS/PSUIFSO*SFMBOE
DPOöSNJOHUIBUXJUIJO
the twenty four month period immediately preceding the date of the
prospective application, any prospective party was assessed as being, or at
SJTLPGCFJOHBWJDUJNPGEPNFTUJDWJPMFODF
a letter or report from a domestic violence support organisation in the
6OJUFE,JOHEPNBóSNJOH‰
(i)
that any prospective party was, within the twenty four month period
immediately preceding the date of the prospective application,
admitted for a period of twenty four hours or more to a refuge
established for the purpose of providing accommodation for victims
PGPSUIPTFBUSJTLPGEPNFTUJDWJPMFODF
(ii)
the date on which that party was admitted to and, if applicable, left
UIFSFGVHFBOE
(iii) that that party was admitted to the refuge because of allegations by
that party of domestic violence.
Section 13b – Child protection concerns
The applicant confirms that a child would be (i) the subject of the
application and (ii) that child or another child of the family who is living
with that child is currently:
UIFTVCKFDUPGFORVJSJFTCZBMPDBMBVUIPSJUZVOEFSTFDUJPOPGUIF
"DUPS
the subject of a child protection plan put in place by a local authority.
14
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Section 13c – Urgency
The applicant confirms that the application must be made urgently
because:
there is risk to the life, liberty or physical safety of the prospective applicant
PSIJTPSIFSGBNJMZPSIJTPSIFSIPNFPS
any delay caused by attending a MIAM would cause:
"
BSJTLPGIBSNUPBDIJME
#
BSJTLPGVOMBXGVMSFNPWBMPGBDIJMEGSPNUIF6OJUFE,JOHEPNPSBSJTL
of unlawful retention of a child who is currently outside England and
8BMFT
$
BTJHOJöDBOUSJTLPGBNJTDBSSJBHFPGKVTUJDF
%
VOSFBTPOBCMFIBSETIJQUPUIFQSPTQFDUJWFBQQMJDBOUPS
(E) irretrievable problems in dealing with the dispute (including the
JSSFUSJFWBCMFMPTTPGTJHOJöDBOUFWJEFODF
PS
there is a significant risk that in the period necessary to schedule and attend
a MIAM, proceedings relating to the dispute will be brought in another state
JOXIJDIBWBMJEDMBJNUPKVSJTEJDUJPONBZFYJTUTVDIUIBUBDPVSUJOUIBUPUIFS
State would be seised of the dispute before a court in England and Wales.
Section 13d – Previous MIAM attendance or MIAM exemption
The applicant confirms that one of the following applies:
in the 4 months prior to making the application, the person attended a
MIAM or participated in another form of non-court dispute resolution
SFMBUJOHUPUIFTBNFPSTVCTUBOUJBMMZUIFTBNFEJTQVUF
at the time of making the application, the person is participating in another
form of non-court dispute resolution relating to the same or substantially
UIFTBNFEJTQVUFPS
in the 4 months prior to making the application, the person filed a relevant
GBNJMZBQQMJDBUJPODPOöSNJOHUIBUB.*".FYFNQUJPOBQQMJFEBOEUIBU
BQQMJDBUJPOSFMBUFEUPUIFTBNFPSTVCTUBOUJBMMZUIFTBNFEJTQVUF
UIFBQQMJDBUJPOXPVMECFNBEFJOFYJTUJOHQSPDFFEJOHTXIJDIBSF
continuing and the prospective applicant attended a MIAM before initiating
UIPTFQSPDFFEJOHT
UIFBQQMJDBUJPOXPVMECFNBEFJOFYJTUJOHQSPDFFEJOHTXIJDIBSF
DPOUJOVJOHBOEB.*".FYFNQUJPOBQQMJFEUPUIFBQQMJDBUJPOGPSUIPTF
proceedings
15
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Section 13e – Other exemptions
The applicant confirms that one of the following other ground for
exemption applies:
UIFQSPTQFDUJWFBQQMJDBOUEPFTOPUIBWFTVóDJFOUDPOUBDUEFUBJMTGPSBOZPG
the prospective respondents to enable a family mediator to contact any of
UIFQSPTQFDUJWFSFTQPOEFOUTGPSUIFQVSQPTFPGTDIFEVMJOHUIF.*".
the application would be made without notice (Paragraph 5.1 of Practice
Direction 18A sets out the circumstances in which applications may be
made without notice.)
(i) the prospective applicant is or all of the prospective respondents are
subject to a disability or other inability that would prevent attendance at a
.*".VOMFTTBQQSPQSJBUFGBDJMJUJFTDBOCFPòFSFECZBOBVUIPSJTFENFEJBUPS
(ii) the prospective applicant has contacted as many authorised family
NFEJBUPSTBTIBWFBOPóDFXJUIJOöGUFFONJMFTPGIJTPSIPNFPSUISFFPG
them if there are three or more), and all have stated that they are unable to
QSPWJEFTVDIGBDJMJUJFTBOEJJJ
UIFOBNFTQPTUBMBEESFTTFTBOEUFMFQIPOF
numbers or e-mail addresses for such authorised family mediators, and the
EBUFTPGDPOUBDUDBOCFQSPWJEFEUPUIFDPVSUJGSFRVFTUFE
the prospective applicant or all of the prospective respondents cannot
attend a MIAM because he or she is, or they are, as the case may be (i) in
QSJTPOPSBOZPUIFSJOTUJUVUJPOJOXIJDIIFPSTIFJTPSUIFZBSFSFRVJSFEUPCF
EFUBJOFEJJ
TVCKFDUUPDPOEJUJPOTPGCBJMUIBUQSFWFOUDPOUBDUXJUIUIFPUIFS
QFSTPOPSJJJ
TVCKFDUUPBMJDFODFXJUIBQSPIJCJUFEDPOUBDUSFRVJSFNFOUJO
relation to the other person.
the prospective applicant or all of the prospective respondents are not
IBCJUVBMMZSFTJEFOUJO&OHMBOEBOE8BMFT
BDIJMEJTPOFPGUIFQSPTQFDUJWFQBSUJFTCZWJSUVFPG3VMF
(i) the prospective applicant has contacted as many authorised family
NFEJBUPSTBTIBWFBOPóDFXJUIJOöGUFFONJMFTPGIJTPSIFSIPNFPSUISFF
of them if there are three or more), and all of them have stated that they are
not available to conduct a MIAM within fifteen business days of the date
PGDPOUBDUBOEJJ
UIFOBNFTQPTUBMBEESFTTFTBOEUFMFQIPOFOVNCFST
or e-mail addresses for such authorised family mediators, and the dates of
DPOUBDUDBOCFQSPWJEFEUPUIFDPVSUJGSFRVFTUFE
UIFSFJTOPBVUIPSJTFEGBNJMZNFEJBUPSXJUIBOPóDFXJUIJOöGUFFONJMFTPG
the prospective applicant’s home
Now complete Section 16.
16
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.FEJBUPSDFSUJöFTUIBUBQQMJDBOUJTFYFNQUGSPNBUUFOEBODFBU.FEJBUJPO*OGPSNBUJPO
and Assessment Meeting (MIAM)
(To be completed and signed by the authorised family mediator)
(tick the boxes that apply)
The following MIAM exemption(s) applies:
An authorised family mediator confirms that he or she is satisfied that (a) mediation is not suitable as a means of resolving the dispute because
OPOFPGUIFSFTQPOEFOUJTXJMMJOHUPBUUFOEB.*".PS
(b) mediation is not suitable as a means of resolving the dispute because
all of the respondents failed without good reason to attend a MIAM
BQQPJOUNFOUPS
(c) mediation is otherwise not suitable as a means of resolving the
dispute.
Signed
Authorised Family Mediator
(a family mediator who is authorised to undertake MIAMs)
Family
Mediation
Service name
Address
Dated
D
D
/
M M
/
Y
Y
Y
Y
Applicant or Legal representative to complete and sign Section 16.
17
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15. Confirmation of attendance at a Mediation Information and Assessment Meeting (MIAM)
(To be completed by an authorised family mediator)
The applicant has attended a MIAM to find out about and consider family
mediation.
The respondent part or parties also attended thie MIAM with the applicant to
find out about and consider family mediation.
The respondent party or parties has/have made or is/are making arrangements
to attend a separate MIAM to find out about and consider family mediation.
Mediation or other form of Dispute Resolution is not proceeding
because:
One or more of the people involved in the dispute have attended a Mediation
Information and Assessment Meeting, but none decided to start or continue
with mediation
One or more of the people involved in the dispute attended a Mediation
Information and Assessment Meeting and was/were willing to mediate but
the mediator has determined that mediation is unsuitable
Mediation started but has either broken down or concluded with issues
unresolved.
Signed
Authorised Family Mediator
(a family mediator who is authorised to undertake MIAMs)
Family
Mediation
Service name
Address
Dated
D
D
/
M M
/
Y
Y
Y
Y
Applicant or Legal representative to complete and sign Section 16.
18
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16. Statement of truth
*[I believe] [The applicant/respondent believes] that the facts stated in this
application are true.
*delete as
appropriate *I am duly authorised by the applicant/respondent to sign this statement.
Print full name
Name of applicant solicitors firm
Signed
Dated
D
D
/
M M
/
Y
Y
Y
Y
(Applicant) (Applicant‘s solicitor)
1PTJUJPOPSPóDFIFME
(If signing on behalf of firm or
company)
Proceedings for contempt of court may be brought against a person who
makes or causes to be made, a false statement in a document verified by
a statement of truth.
19
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Checklist for completing form C100
Relevant sections of this application will be provided to Cafcass upon issue of proceedings. The information contained
JOQBHFTUPPGUIJTGPSNFOBCMFT$BGDBTTUPDPOEVDUFORVJSJFTQSJPSUPUIFöSTUDPVSUIFBSJOHXJUIPVUJUUIFZDBOOPU
DPOEVDUUIFJSJOJUJBMTBGFHVBSEJOHDIFDLTBOEFORVJSJFT
8IJMTUFWFSZRVFTUJPOJOQBHFTUPPGUIJTGPSNTIPVMECFDPNQMFUFEPSTUBUFEUIBUJOGPSNBUJPOJTOPUBWBJMBCMFUIF
GPMMPXJOHFTTFOUJBMJOGPSNBUJPOJTSFRVJSFECZ$BGDBTT$"'$"44$:.36BOEGBJMVSFUPQSPWJEFUIJTJOGPSNBUJPODPVME
lead to unnecessary delays to proceedings:
Page 1
Page 6
Write in your full names
Tick the type of order you are applying for
Tick whether the application is urgent
Tick whether the application is to be made without
notice to another party
Tick if you are your application is for an order to
formalise an agreement (consent order)
Tick to indicate whether there are linked
"OTXFSRVFTUJPOBCZUJDLJOHUIFSFMFWBOUCPY
to indicate whether you previously prepared a
Parenting Plan).
"OTXFSRVFTUJPOBBCPVUSJTLCZUJDLJOHUIF
SFMFWBOUCPYT
*GZPVBOTXFSFEA:FTGPSBOZPG
UIFTFCPYFTZPVTIPVMEBMTPDPNQMFUFBOETVCNJU
to the court with your application a completed
supplemental information form C1A.
*GZPVUJDLFEUIFCPYPOQBHFUPJOEJDBUFMJOLFE
proceedings, please complete section 6a which
asks for further details.
QSPDFFEJOHTBOEJGTPQSPWJEFEFUBJMTJOUIFCPYFT
Page 2
Page 7
The full name(s) of the child(ren) in the
proceedings
Their date(s) of birth
Their gender
The applicants relationship to the child(ren)
The respondents relationship to the child(ren)
"OTXFSRVFTUJPOTBBOECCZUDLJOHUIFSFMFWBOU
CPYFTBOEQSPWJEFEFUBJMTJOUIFCPYPGBOZTQFDJBM
arrangements you need in order to be able to
attend court.
Page 8
Your (applicant’s) full name
Any previous names
Your (applicant’s) gender and date of birth
Your (applicant’s) address, including the Postcode
Note: if you (the applicant) does not wish the
address to be made known it should be included in
an accompanying form C8.
Your (the applicant’s) telephone number and if
applicable, mobile telephone.
Page 3
"OTXFSRVFTUJPOBXIFUIFSUIFSFBSFQBSBMMFM
proceedings for an emergency protection order,
care order or supervision order) by ticking the
SFMFWBOUCPYFT
"OTXFSRVFTUJPOCXIFUIFSZPVBSFDMBJNJOH
FYFNQUJPOGSPNUIFSFRVJSFNFOUUPBUUFOEB.*".
"OTXFSRVFTUJPODXIFUIFSBGBNJMZNFEJBUPSIBT
JOGPSNFEZPVUIBUBNFEJBUPSTFYFNQUJPOBQQMJFT
"OTXFSRVFTUJPOEXIFUIFSZPVIBWFBUUFOEFEB
MIAM).
Page 9
Page 4
"OTXFSRVFTUJPOTBUPEBCPVUUIFDIJMESFO
XIP
BSFUIFTVCKFDUPGZPVSBQQMJDBUJPOCZUJDLJOHCPYFT
and providing details where appropriate.
Page 5
The respondent’s full name
Previous surnames (if known)
The respondent’s gender and date of birth
The respondent’s address, including the Postcode
The respondent’s telephone number and if
applicable, mobile telephone
Page 10
5JDLXIFUIFSQFSNJTTJPOUPJTSFRVJSFEUPNBLFBO
application
Complete section 3a to provide brief details about
why you are making the application
If you ticked ‘application urgent’ on page 1,
complete section 3b.
If you ticked ‘application made without notice to
another party’ on page 1, complete section 3c
Whether the respondent has lived at their address
for more than 5 years
Full details in section 10 for other parties who
should be given notice of the application
Page 11
Solicitor’s details (if applicable), including a
telephone number
20
C100_0414_4.indd 20
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Page 12
Page 17
*GZPVBOTXFSFERVFTUJPOCPOQBHFXJUIA:FT
ZPVNVTUUJDLUIFSFMFWBOUCPYIFSFUPJOEJDBUFUIF
DBUFHPSZPG.*".FYFNQUJPOUIBUZPVBSFDMBJNJOH
You (and your legal representative if relevant)
TIPVMEUIFOTJHOBOEEBUFUIFCPYFTTIPXOBOE
then go to page 13.
If a family mediator has informed you that a
NFEJBUPSTFYFNQUJPOBQQMJFTZPVNVTUBTLUIFN
to complete and sign this page of the form.
Page 18
If you have attended a MIAM you must ask the
family mediator who conducted it to complete and
sign this page of the form.
Page 13 to 16
*GZPVBSFDMBJNJOHBOFYFNQUJPOGSPNBUUFOEBODF
BUB.*".ZPVNVTUUJDLUIFSFMFWBOUCPYJO
sections 13a to 13e to tell the court more about
ZPVSDMBJNFEFYFNQUJPO
Page 19
Check that you (and your solicitor if relevant) have
completed and signed Section 16.
General information for
completing this form
1.
3.
4.
If you are aware of any previous or current court
cases concerning the child(ren) who would be the
subject of the Section 8 order you are seeking then
ZPVNVTUUJDLUIFCPYPOQBHFUPJOEJDBUFUIJTBOE
QSPWJEFBTNVDIJOGPSNBUJPOBTZPVDBOJOUIFCPYFT
and at Section 6a of this form.
6.
If you are applying for an order by consent you
TIPVMEUJDLUIFCPYPOQBHFUPNBLFUIJTDMFBSBOE
attach the draft order with the C100 form.
You need to complete this form if you want to ask the
DPVSUUPNBLFPSDIBOHFBOFYJTUJOHPSEFS
BCPVUB
child(ren) and your application is for:
t
BDIJMEBSSBOHFNFOUTXIFSFBDIJMETIPVMEMJWF
XIPBDIJMETIPVMETQFOEUJNFXJUIPSCPUI
PS
t
BTQFDJöDJTTVFPSEFSGPSFYBNQMFJGZPVBSF
asking the court to decide whether a child’s
TVSOBNFTIPVMECFDIBOHFE
PS
t
2.
5.
Requirement to attend a Mediation,
Information and Assessment Meeting
BQSPIJCJUFETUFQTPSEFSGPSFYBNQMFJGZPV
are asking the court to prevent a person from
removing a child from a school).
*UJTOPXBMFHBMSFRVJSFNFOUUIBUVOMFTTBO
FYFNQUJPOBQQMJFTBQFSTPOXIPXJTIFTUPBQQMZUP
court for one or more of the orders listed above must
first attend a Mediation, Information and Assessment
Meeting (a MIAM). At the stage before proceedings
UIFPUIFSQBSUZUIFSFTQPOEFOU
JTFYQFDUFEUP
attend either the same MIAM or a separate MIAM.
These orders are known as “Section 8 orders”. You
NVTUUJDLUIFSFMFWBOUCPYPOQBHFUPJOEJDBUF
which type of order(s) you are applying for. (If you
wish to ask the court to enforce a previous Section 8
order you need to complete a different court form –
the C79).
8.
Pages 1 to 11 set out the core information you need
to provide if you wish to make an application to the
court. You also need to ensure that relevant Sections
12 to 15 are completed and that your or your solicitor
sign and date the Statementr of Truth in Section 16
of this form. Your application cannot be processed
unless either Section 12 or Section 13 or Sections 14
and 15 have been completed and signed and your
IBWFBOTXFSFEBTNBOZRVFTUJPOTBTQPTTJCMFBU
pages 1 to 11.
At the MIAM, a trained family mediator will give you
(the applicant) and the other person if present (the
respondent) information about family mediation
and other types of non-court dispute resolution.
They will consider with you whether non-court
dispute resolution would be an appropriate way to
resolve the dispute. It is then for the applicant and
respondent to decide whether or not to do so.
5IFSFRVJSFNFOUGPSUIFBQQMJDBOUUPBUUFOEB.*".
does not apply if a Section 8 order is being applied
for and:
If your application is urgent, or if you are making
your application without notice to another party UIFSFTQPOEFOUT
ZPVNVTUUJDLUIFSFMFWBOUCPYPO
page 1 of this form. You must then provide details in
the relevant Section, as indicated on page 1.
t
UIFPUIFSQFSTPOJTJOBHSFFNFOUBCPVUXIBU
you are asking the court to order (the order is a
iDPOTFOUPSEFSw
PS
t
UIFSFJTBOPOHPJOHDBTFBCPVUUIFDIJMESFO
who would be the subject of the Section
8 application and that case concerns an
emergency protection order, a supervision order
or a care order, or if one of those orders has
previously been made.
21
C100_0414_4.indd 21
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in supporting Practice Direction (judicial guidance)
3A. These are available online at:
www.justice.gov.uk/courts/procedure-rules/family/
practice_directions/pd_part_03a
:PVNVTUUJDLUIFSFMFWBOUCPYPOQBHFPGUIJT
form so that the court knows whether the MIAM
SFRVJSFNFOUBQQMJFTXIFUIFSBOFYFNQUJPOBQQMJFT
(and why) or whether you have attended a MIAM.
You must also complete the relevant section(s of the
form as indicated on page 3. Your application will
not be processed (issued) unless you complete these
parts of the form.
Paying for MIAM attendance or for family
mediation
:PVNBZRVBMJGZGPSMFHBMBJEJGZPVNFFUPOFPSNPSF
forms of evidence for domestic violence or child
protection concerns (see paragraph 29 below for
how to check eligibility for legal aid).
MIAM exemptions and MIAM attendance
"TUIFBQQMJDBOUZPVBSFFYQFDUFEUPIBWFDPOUBDUFE
a family mediator in order to make arrangements to
attend a MIAM unless :
t
UIF.*".SFRVJSFNFOUEPFTOPUBQQMZGPSPOF
PGUIFSFBTPOTFYQMBJOFEBUQBSBHSBQIPGUIFTF
notes, or
t
ZPVBSFDMBJNJOHB.*".FYFNQUJPOPSBGBNJMZ
NFEJBUPSDFSUJöFTUIBUBNFEJBUPSTFYFNQUJPO
applies.
20. Please note: the family mediator will discuss with you
and the other person whether you wish to attend the
MIAM separately or together. Family mediators have
a responsibility to ensure the safety and security of all
concerned and will always check with each of you that
attending together is your individual choice and is safe.
Information about mediation
21. If suitable, mediation can be a better way of resolving
issues about arrangements for children when you
and your partner separate or divorce. Mediation can
CFMFTTFYQFOTJWFUIBOHPJOHUPDPVSUJOUIFMPOH
run and much less stressful on all the family. It can
also help you as parents to focus on your child(ren)’s
needs in making decisions about them.
12. You should give the mediator the contact details
of the other person so that the family mediator can
contact them to check their willingness to attend
a MIAM. If the other persons (or none of the other
persons if there is more than one respondent) is or
are unwilling to attend a MIAM this is a ground for
UIFGBNJMZNFEJBUPSUPFYFNQUZPVGSPNBUUFOEJOHB
MIAM.
22. Family Mediation is a process that involves an
independent third person who assists both parties
involved in a family dispute to reach a resolution.
Family mediation can be used to settle any of the
following issues:
13. If you or your solicitor believe that you have grounds
GPSDMBJNJOHFYFNQUJPOGSPN.*".BUUFOEBODFZPV
PSZPVSTPMJDJUPSNVTUUJDLUIFSFMFWBOUCPYPOQBHF
3 of the form and complete and sign where shown
Sections 12 and 13 of this form.
14. If a family mediator wishes to certify that a mediator’s
FYFNQUJPOBQQMJFTBOEZPVEPOPUOFFEUPBUUFOEB
MIAM you must ask the family mediator to complete
and sign Section 14 of this form.
15. If you have attended a MIAM you must ask the family
mediator who conducted the MIAM to complete and
sign Section 15 of this form.
t
"SSBOHFNFOUTGPSDIJMESFO
t
'JOBODJBMBSSBOHFNFOUTBOEEJWJEJOHVQ
property
t
"OZDPNCJOBUJPOPGUIFTF
t
"OZPUIFSEJTQVUFTUPEPXJUITFQBSBUJPOBOE
divorce.
23. Family Mediation is not just for divorcing or
separating couples – it is a means for resolving a
range of family disputes whether they arise from
divorce or separation of cohabiting parents Family
Mediation could also help resolve issues with wider
family members such as grandparents.
*GZPVDMBJNB.*".FYFNQUJPOBOENBLFBO
BQQMJDBUJPOUPUIFDPVSUUIFDPVSUXJMMJORVJSFJOUP
UIFUIFHSPVOETGPSFYFNQUJPO5IFDPVSUNBZBTL
you to produce written evidence (see Section 13 of
UIJTGPSNGPSEFUBJMTBHBJOTUFBDIFYFNQUJPOTIPXO
24. Mediation is a completely neutral process which
involves an impartial mediator facilitating
negotiation between the parties to agree their
own arrangements by way of a Memorandum of
6OEFSTUBOEJOH:PVDBOBTLBTPMJDJUPSJGZPVIBWF
POFUPDIFDLUIF.FNPSBOEVNPG6OEFSTUBOEJOH
*GUIFDPVSUEFUFSNJOFTUIBUUIFFYFNQUJPOXBT
wrongly claimed it may direct you to attend a MIAM
and, if the case has already progressed to the first
hearing, may adjourn the case to enable to make
arrangements to attend a MIAM. The court also has
the power to direct the other person(s) in the case
(the respondents) to attend a MIAM if they did not
do so before you made your Section 8 application.
25. Some mediators and solicitors are working together
UPQSPWJEFöYFEGFFQBDLBHFTGPSNFEJBUJPOXIJDI
includes legal help and advice. If you are eligible
for legal aid for family mediation you could receive
mediation free of charge and some advice from a
solicitor to support you in the mediation process.
18. The detailed procedure relating to the MIAM
SFRVJSFNFOUBOE.*".FYFNQUJPOTBOEBUUFOEBODF
is set out in Part 3 of the Family Procedure Rules and
22
C100_0414_4.indd 22
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26. If both parties agree, you can ask the court to
endorse what you have agreed by issuing a consent
order. The mediator will help you to decide whether
your case is complicated and does in fact need
the court to consider your situation and make an
order. The mediator should also tell you about other
localservices and options for resolving your dispute.
Further information and sources of help
27. A family mediation service finder is available within
UIF(PW6,XFCTJUFQSFWJPVTMZLOPXOBT%JSFDU(PW
at:
www.familymediationhelpline.co.uk/find-service.php
28. The family mediator who undertakes the MIAM
for you must be a member of a national mediation
organisation which adheres to the Family Mediation
Council’s Code of Conduct and the mediator must be
authorised to conduct MIAMs. The service finder will
help you find such a mediator.
29. You can find out more about legal aid, including
whether you may eligible for legal aid on the new
-FHBM"JE*OGPSNBUJPO4FSWJDFPOUIF(PW6,TJUFBU
www.gov.uk/check-legal-aid
or you can telephone the Civil Legal Advice direct
helpline 0845 345 4345.
30. Alternatively the web app Sorting Out Separation is
now available at: www.sortingoutseparation.org.uk
31. The app provides information on services as well as
An Action Plan and a link to legal aid information.
23
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24
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