Form FL-10 Clerk’s stamp: COURT FILE NUMBER

COURT Provincial Court of Alberta Court of Queen’s Bench of Alberta COURT LOCATION / JUDICIAL CENTRE

APPLICANT(S) Address for service and contact information for the Applicant(s)

RESPONDENT(S) Last known address and contact information for the Respondent(s)

DOCUMENT Claim – Family Law Act

NOTICE TO THE RESPONDENT(S): This application is made against you. You are a Respondent. You have the right to state your side of this matter before the Court. To do so, you must be in Court when the application is heard as shown below: Court Date: Time: Where:

Go to the end of this document to see what you can do and when you must do it.

1. I ask the Court to grant the following order(s): Guardianship Form # Spousal/Partner Support Form # Guardianship of Child FL-34 or FL-35 Spousal/Partner Support FL-48 Terminate Guardianship FL-36 Vary Support Order FL-49 or FL-50 Review of Guardian’s Significant Decision FL-37 Enforcement (Time with Child) Court Direction for Guardian FL-38 Enforcement (Time with Child) FL-51 Parenting Reimbursement for Failure to Exercise Time FL-52 Parenting of Child FL-39 or FL-40 Vary Enforcement Order FL-53 Vary a Parenting Order FL-41 Matters Available only in Queen’s Bench Contact Exclusive Possession of Home/Goods FL-54 Contact with Child FL-42 Declaration of Parentage FL-55 Vary a Contact Order FL-43 Declaration of Irreconcilability FL-56 Leave of Court (to apply for contact) FL-44 Other Child Support specify: Child Support FL-45 Vary Child Support Order FL-46 or FL-47

2. Children involved in this application: (List full name and birthdate (yyyy/mm/dd) of each child) (a) / / ; (d) / / ; (b) / / ; (e) / / ; (c) / / ; (f) / / ;

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3. Have you been involved in other legal proceedings (past or present) with the Respondent(s) or the children?

Yes No

4. Basis for this claim: (summarize what you are asking for and why)

(a)

5. Evidence in support of this claim: (list the Statement(s) or Affidavit(s) you will use)

(a)

WARNING If you do not come to Court either in person or by your lawyer, the Court may give the Applicant(s) what the Applicant wants in your absence. You will be bound by any order that the Court makes. If you wish to respond to the Claim, you must file a Response with the Court. If you disagree with some or all of the orders asked for by the Applicant(s), and you want the Court to know your side of this matter, you must file Reply Statement(s) or an affidavit to support your position. You must serve all your documents on the Applicant(s) within a reasonable time before the court date shown above, but anything less than 10 days’ notice will be presumed to be prejudicial to the Applicant(s). Family Law Act forms you can use to respond are available from the courthouse or visit: www.albertacourts.ab.ca.

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