Consent Orders Questionnaire

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Consent Orders Questionnaire

Please complete all sections of this intake form. Required fields are marked with an asterisk.

Section 1 – Your Details

Please provide your personal details below.

Full Name(Required)

Residential Address

Postal Address

Leave blank if same as residential address

Phone(Required)

Email(Required)

Date of Birth

Place of Birth

Citizenship Status

Gender

Are you of Aboriginal and/or of Torres Strait Islander origin?

Languages Spoken

Language

Proficiency (1/3/5)

Add one row per language. Proficiency: 1 = basic, 3 = conversational, 5 = fluent.

Section 2 – Your Employment

Occupation

If not working, just enter retired/unemployed/etc as best matches you

Employer Name

Qualifications (if any)

Anticipated Changes (if any)

Any expected changes to your employment.

Section 3 – Other Party Details

Other Party Full Name(Required)

Other Party Residential Address

Other Party Postal Address (if different)

Other Party Phone

Other Party Email

Other Party Date of Birth

Gender

Is the Other Party of Aboriginal and/or of Torres Strait Islander origin?

Other Party Place of Birth

Other Party Citizenship Status

Other Party Languages

Language

Proficiency (1/3/5)

Add one row per language. Proficiency: 1 = basic, 3 = conversational, 5 = fluent.

Section 4 – Other Party Employment

Other Party Occupation

Other Party Employer Name

Other Party Qualifications (if any)

Other Party Anticipated Changes

Eg. about to start a new job, has resigned and will cease working in 2 weeks, etc

Section 5 – Relationship Information

When did you begin living together?

Date Married (if applicable)

Where did you get married?

Date Separated (if applicable)

Where did you get divorced?

If you are seeking financial or property orders, and you are applying outside the usual time limit (12 months after divorce, or 2 years after separation for de facto couples), do you consent to this application proceeding?

Yes

Section 6 – About other Court cases and orders

Are there any ongoing cases in this or any other court about family law, child support, family violence or child welfare that involve any of the parties or any of the children listed on this form?

Yes

Are there any existing orders, agreements, parenting plans or undertakings to a court about family law, child support, family violence or abuse in relation to a child (including orders which have applied to a child or a member of the child’s family), or child welfare, concerning any of the parties or children listed on this form?

Yes

Has there been any contact with the department responsible for child safety with respect to the children named in this application or any child of the household?

Yes

If yes, provide details including the outcome of that contact and any outstanding concerns.

Are you seeking a parenting order that provides for the child’s parents to have joint or sole decision-making in relation to major long-term issues?

One parent to have sole decision making in relation to all major long-term issues.

Both parents to have joint decision-making in relation to all major long-term issues.

One parent to have sole decision-making in relation to some major long-term issues, with both parents to have joint decision-making in relation to some major long-term issues.

Provide details and explain why it is in the child’s best interests for that order to be made.

Are you seeking a parenting order that provides for the child to spend time with each of the child’s parents?

Yes

Briefly explain why/why not this is in the best interest of the child.

Have the parties previously entered into a financial agreement, a Part VIIIAB financial agreement or a superannuation agreement under the Family Law Act or under any relevant State or Territory legislation?

Yes

If you have copies, upload here. Otherwise, please bring copies to our next meeting

Drop files here or

Max. file size: 512 MB, Max. files: 10.

If either party has a superannuation interest, has the non-member spouse or former de facto partner served a waiver notice on the Trustee of the eligible superannuation fund under section 90XZA of the Act for a payment split made in relation to the superannuation interest?

Yes

If you have copies, upload here. Otherwise, please bring copies to our next meeting

Drop files here or

Max. file size: 512 MB, Max. files: 10.

If either party has a superannuation interest, is there a payment flag in operation in relation to that interest?

Yes

If you have copies, upload here. Otherwise, please bring copies to our next meeting

Drop files here or

Max. file size: 512 MB, Max. files: 10.

Is any party currently bankrupt or currently a debtor in bankruptcy proceedings started by either a creditor's petition or a debtor's petition or currently a debtor subject to a personal insolvency agreement?

Yes

Is there a proceeds of crime order or current forfeiture application in relation to any of the property of any of the parties (see Proceeds of Crime Act 2002 (Cth))?

Yes

If you have copies, upload here. Otherwise, please bring copies to our next meeting

Drop files here or

Max. file size: 512 MB, Max. files: 10.

Section 7 – Children Information

Children

Family Name

Given Name

Date of Birth

M/F/X

Primary care giver

Add one row per child.

Who else lives in the child’s home when the child is living with the applicant and when the child is living with Party B?

Father

Mother

Other person

If other person, please include age, gender, name and relationship to child.

Section 9 – Details for parenting orders

Housing Arrangements

(e.g. 3 bedroom house – child has own room).

Supervision

(who looks after the child? e.g. If the parent who lives with the child is working outside the home who looks after the child during the parent’s absence).

Financial support

(details about maintenance and child support, including details of maintenance orders or child support assessments and what is actually being paid or proposed to be paid by any parent or party to the marriage who does not live with the child).

Health

(details of the health of the child and any treatment or ongoing medication needs).

Education

(details about what school the child attends, what year they are in and what progress is being made).

Any other matters

(for example, any other arrangements not set out above which promotes the safety of the child and their carers, promotes the developmental, psychological, emotional and cultural needs of the child, including for a child that is Aboriginal or Torres Strait Islander, their right to enjoy that culture – see section 60CC of the Family Law Act).

Risk of abuse, neglect or family violence

Child abuse or neglect, or risk of child abuse or neglect

Yes

Family violence or risk of family violence

Yes

Mental ill-health

Yes

Drug or alcohol abuse

Yes

Serious parental incapacity

Yes

Any other allegation involving risk to the child or children

Yes

Section 10 – De facto relationship jurisdiction – financial clauses

Complete all the boxes below as required if relying on the Court’s jurisdiction to make orders for the benefit of a party to a de facto relationship that has broken down.

Did your de facto relationship break down on or after 1 March 2009 or if resident in South Australia on or after 1 July 2010?

Yes

If no, complete item (a) and (c) as required. If yes, complete item (d)

(a) Do both parties each choose for Parts VIIIAB and VIIIB, and subsection 114(2A) of the Family Law Act 1975 to apply in relation to your de facto relationship?

Yes

If yes, attach copies of your written and signed consent and statement of legal advice by a legal practitioner

Max. file size: 512 MB.

(b) Have the parties previously entered into a designated State/Territory financial agreement in relation to their de facto relationship

Yes

If no, complete item (d), If yes, complete item (c)

(c) Has that agreement ceased to have effect without any property being distributed or any maintenance being paid under the agreement?

Yes

(d) Is the period or the total of the periods of the de facto relationship at least 2 years?

Yes

Is there a child of the de facto relationship?

Yes

Have the parties made substantial contributions during the relationship?

Yes

(e.g. financial contribution to children of the de facto relationship or to acquisition/conservation to property?)

Is, or was, the relationship registered under a prescribed law of a State or Territory of Australia?

Yes

If yes, upload a copy of the certificate of registration or other proof

Max. file size: 512 MB.

Was either or both of the parties to the de facto relationship ordinarily resident in one or more of the Australian Territories or New South Wales, Queensland, Victoria, Tasmania or South Australia when the relationship broke down?

Yes

Are either or both of the parties to the de facto relationship ordinarily resident in one or more of the Australian Territories or New South Wales, Queensland, Victoria, Tasmania or South Australia at the time this application is made?

Yes

Were both of the parties to the de facto relationship ordinarily resident in one or more of the Australian Territories or New South Wales, Queensland, Victoria, Tasmania or South Australia for at least one third of the de facto relationship?

Yes

Section 11 – Details for financial or property orders

Gross weekly income – PARTY A (yourself)

Gross weekly income – PARTY B (your partner/ex partner)

Do the orders sought affect your earning capacity?

Yes

If yes, give details

Do the orders sought affect Party B's earning capacity?

Yes

If yes, give details

Are you paying child support?

Yes

Are you paying child support? – PARTY B

Yes

If yes, please detail amount paid per week and paid to (name)

If yes, please detail amount paid per week and paid to (name) – PARTY B

Are you receiving child support?

Yes

Are you receiving child support? – PARTY B

Yes

If yes, please detail amount received each week and paid to you by (name)

If yes, please detail amount received each week and paid to you by (name) – PARTY B

Property

Shared property: If you own any property jointly with the other party to this application or any other person, then show the market value of your individual share in that property.

Real estate – PARTY A

Address

Your % share

Value of your share

Real estate – PARTY B

Address

Your % share

Value of your share

Motor vehicles – PARTY A

Make

Model

Value of your share

Motor vehicles – PARTY B

Make

Model

Value of your share

Furniture, furnishings and effects. List value of Party A's share

Furniture, furnishings and effects. List value of Party B's share

Funds in banks, building societies, credit unions or other financial institutions – PARTY A

Name of institution

Your share

Account number

Funds in banks, building societies, credit unions or other financial institutions – PARTY B

Name of institution

Your share

Account number

Interest in any business – PARTY A

Name of business

Your % share

Value of your share

(give best estimate of the gross market value)

Interest in any business – PARTY B

Name of business

Your % share

Value of your share

(give best estimate of the gross market value)

Investments including shares in public companies – PARTY A

Name and type of investment

Number shares held/Your% share

Value

Investments including shares in public companies – PARTY B

Name and type of investment

Number shares held/Your% share

Value

Life insurance policies – PARTY A

Company

Policy No.

Surrender value of your shares

Life insurance policies – PARTY B

Company

Policy No.

Surrender value of your shares

Interest in any other property, including leased property – PARTY A

Give details

Value of your share

Interest in any other property, including leased property – PARTY B

Give details

Value of your share

TOTAL value of property owned by Party A (you)

TOTAL value of property owned by Party B

Liabilities

Amount owning on home mortgage – PARTY A

Name of lender

Address of property

Your share of amount owing

Amount owning on home mortgage – PARTY B

Name of lender

Address of property

Your share of amount owing

Amount owning on any other mortgage – PARTY A

Name of lender

Address of property

Your share of amount owing

Amount owning on any other mortgage – PARTY B

Name of lender

Address of property

Your share of amount owing

Amounts owing on any credit/charge cards – PARTY A

Type of card

Your share of amount owing

Amounts owing on any credit/charge cards – PARTY B

Type of card

Your share of amount owing

Amounts owing on any other loans – PARTY A

Give details

Name of lender/s

Your share of amount owing

Amounts owing on any other loans – PARTY B

Give details

Name of lender/s

Your share of amount owing

Income tax liabilities – PARTY A

Current financial year

Amount unpaid from previous financial years

Income tax liabilities – PARTY B

Current financial year

Amount unpaid from previous financial years

TOTAL liabilities – PARTY A

TOTAL liabilities – PARTY B

Total net worth

To calculate your total net worth, subtract the amounts given at TOTAL in the Property section from the amounts TOTAL in Liabilities.

TOTAL VALUE OF PROPERTY OWNED BY YOU

TOTAL VALUE OF PROPERTY OWNED BY OTHER PARTY

YOUR TOTAL LIABILITES

OTHER PARTY'S TOTAL LIABILITES

YOUR TOTAL NET WORTH

OTHER PARTY'S TOTAL NET WORTH

Has either party acquired or disposed of any property since the date of separation?

Yes

Has either party acquired or disposed of any property since the date of separation?

Yes

If yes, give details

Superannuation

If you have a superannuation interest, attach proof of value of the interest when a splitting order is sought (eg: a statement from your superannuation fund with a current value) If you have more than one superannuation interest: · attach proof of value for each interest when a splitting order is sought · attach a list of the interests · include the details required in Items 61-66 for each interest

Name of eligible superannuation fund

Name of other party's eligible superannuation fund

Type of interest – PARTY A

accumulation interest

partially vested accumulation interest

defined benefit interest

self managed fund

retirement savings account

small superannuation account

percentage only interest

approved deposit fund

eligible annuity

Type of interest – PARTY B

accumulation interest

partially vested accumulation interest

defined benefit interest

self managed fund

retirement savings account

small superannuation account

percentage only interest

approved deposit fund

eligible annuity

Specify the current agreed gross value of the interest in superannuation – PARTY A

Specify the current agreed gross value of the interest in superannuation – PARTY B

In respect to the above value:

I confirm the above value is current (dated not more than 3 months prior to the date of this Application)

Has the agreed value in Item 63 been calculated in accordance with the Family Law (Superannuation) Regulations 2025?

In respect to the above value:

I confirm the above value is current (dated not more than 3 months prior to the date of this Application)

Has the agreed value in Item 63 been calculated in accordance with the Family Law (Superannuation) Regulations 2025?

Not applicable where parties intend to retain their respective superannuation

For each interest, whether or not a splitting order is sought, advise if the interest is subject to an earlier payment split.

Yes – Are there any further payments to be made?

For each interest, whether or not a splitting order is sought, advise if the interest is subject to an earlier payment split.

Yes – Are there any further payments to be made?

Further payments?

Yes – Provide the following details

Further payments?

Yes – Provide the following details

PARTY A

The operative time for the split

The amount of any future payments in respect of a base amount split in the payment phase (where applicable)

The adjusted base amount where the interest is in the growth phase (where applicable)

The specified percentage in the case of a percentage split (where applicable)

PARTY B

The operative time for the split

The amount of any future payments in respect of a base amount split in the payment phase (where applicable)

The adjusted base amount where the interest is in the growth phase (where applicable)

The specified percentage in the case of a percentage split (where applicable)

PARTY A: For each interest, whether or not a splitting order is sought:

If the interest is a defined benefit interest in the growth phase (not being an interest in a constitutionally protected fund), state the amount of any surcharge debt in the most recent member statement

If the interest is in a constitutionally protected fund, state the amount of any surcharge in the surcharge debt account

PARTY B: For each interest, whether or not a splitting order is sought:

If the interest is in a constitutionally protected fund, state the amount of any surcharge in the surcharge debt account

Financial Resources

Interest in any trust or any other financial resources (for example, do you have an expectation of receiving money from a personal injury claim or Court case or property from a deceased estate?) – PARTY A

Proposed percentage division of finances

Proposed percentage division of the property (including superannuation)

PARTY A %

PARTY B %

PARTY B

Agree

Disagree

If disagree, give brief reasons why you disagree and specify your estimate of the proposed divison

Were the financial contributions of the parties the same? PARTY A

Yes

If no, give brief details of who made the greater contribution

PARTY B

Agree

Disagree

If disagree, give brief reasons why you disagree

Were the non-financial contributions from each of the parties the same?

Yes

If no, give brief details of who made the greater contribution

PARTY B

Agree

Disagree

If disagree, give brief reasons why you disagree

Were the contributions from each of the parties as homemaker and parent the same?

Yes

If no, give brief details of who made the greater contribution

PARTY B

Agree

Disagree

If disagree, give brief details why you disagree

Has family violence by one party affected the ability of the other party to make financial, non-financial and homemaker/ parenting contributions?

Yes

Prefer not to say

If yes, give brief details

PARTY B

Agree

Disagree

Prefer not to say

If disagree, give brief details

Are there any other relevant matters in relation to the division of the property and your current or future needs (e.g. effect of family violence, age/ health of parties, income/ employment capacity/ financial resources, material wastage, care of and responsibilities for children or another person, entitlement to a pension or benefit)? – PARTY A

Yes

If yes, give brief details

PARTY B

Agree

Disagree

If disagree, give brief details

COMPLETE IF SEEKING ORDER IN RELATION TO A PET: Are there any relevant facts in relation to the acquisition, ownership, care of the pet or any facts relating to family violence by one party of the relationship to the other or actual or threatened cruelty by a party to the pet?

Yes

If yes, give brief details

PARTY B

Agree

Disagree

If disagree, give brief details

Section 12 – Effect of financial or property orders sought

Value of the property Party A will receive

Real estate

Motor vehicles

Furniture, furnishings and effects

Funds in banks, building societies, credit unions or other financial institutions

Interest in any business

Investments including shares in public companies

Life insurance policies

Other property

TOTAL

Value of the property Party B will receive

Real estate

Motor vehicles

Furniture, furnishings and effects

Funds in banks, building societies, credit unions or other financial institutions

Interest in any business

Investments including shares in public companies

Life insurance policies

Other property

TOTAL

Liabilities for which Party A will be responsible

Home mortgage

Other mortgage

Loans (total from bank, building society, credit union or other financial institutions)

Credit cards

Hire purchase

Other liabilities – specify

TOTAL

Liabilities for which Party B will be responsible

Home mortgage

Other mortgage

Loans (total from bank, building society, credit union or other financial institutions)

Credit cards

Hire purchase

Other liabilities – specify

TOTAL

TOTAL NET VALUE OF PROPERTY THAT PARTY A WILL RECEIVE

TOTAL NET VALUE OF PROPERTY THAT PARTY B WILL RECEIVE

Section 14 – Additional Information

Urgent Issues

Anything needing immediate attention.

Concerns

Desired Outcomes

What outcomes you hope to achieve.

Additional Comments