Reproduced from Family Courts without a Lawyer www.nofamilylawyer.co.

uk
Witness Statement Template NAME OF PARTY (YOU) INITIALS & SURNAME OF PERSON MAKING STATEMENT WHETHER THIS IS THE PERSONS FIRST / SECOND / THIRD [ETC] STATEMENT NUMBER & INITIALS OF ALL EXHIBITS DATE OF STATEMENT IN THE [XXXX] [COUNTY COURT] CASE NO: [XXXX] BETWEEN: [NAME OF THE PERSON APPLYING FOR AN ORDER] APPLICANT -AND[NAME OF THE OTHER PARTY] [1ST] RESPONDENT [-ANDNAME OF ANY OTHER PARTY EG THE CHILD 2nd RESPONDENT (only if the child has been joined as a party or there is some other party) ]

[1ST / 2ND ETC] WITNESS STATEMENT OF THE [APPLICANT / RESPONDENT ETC] [NAME]

I, [NAME], of [SET OUT ADDRESS or say AN ADDRESS WHICH I WISH TO KEEP CONFIDENTIAL if appropriate], make this statement pursuant to the order dated [DATE] and [in response to [OTHER PARTYS NAME]s application for [ANCILLARY RELIEF / CONTACT ORDER / RESIDENCE ORDER ETC] or in support of my application for [ANCILLARY RELIEF / CONTACT ORDER ETC]]. I am the [XXXX state your relationship to the child and other party ]. If this is your first statement it is usually helpful to identify each of the children and their ages and to state when you got together, when you separated and where each of you is living. All matters contained in this statement are within my own knowledge unless otherwise stated. Set out your evidence here, using a separate paragraph for each issue or topic. If you need to attach a document do it like this: There is now shown to me marked [XXXX insert exhibit no, which is your initials and a number, starting with 01 for the first exhibit, 02 for the second etc] [then say what the exhibit is e.g. a letter from my GP dated XXXX]. Attach each exhibit to the end of the statement with its own cover sheet template below ]. I believe that the facts stated in this statement are true. Signature NAME DATE

Document last updated May 2011