Statement Of Agreed Facts
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3ONTARIO
Court file number
(Name of Court)
Form 33D: Statement of
Agreed Facts
at
(Status Review)
Court office address
Applicant(s)
[In most child protection cases, the applicant will be a children’s aid society.]
Full legal name & address for service — street & number, municipality,
Lawyer’s name & address — street & number, municipality, postal code,
postal code, telephone & fax numbers and e-mail address (if any).
telephone & fax numbers and e-mail address (if any).
Respondent(s)
[In most cases, a respondent will be a “parent” within the meaning of section 37 of the Child and Family Services Act.]
Full legal name & address for service — street & number, municipality,
Lawyer’s name & address — street & number, municipality, postal code,
postal code, telephone & fax numbers and e-mail address (if any).
telephone & fax numbers and e-mail address (if any).
Children’s Lawyer
Name & address of Children’s Lawyer’s agent for service (street & number, municipality, postal code, telephone & fax numbers and e-mail address (if
any)) and name of person represented.
THE PEOPLE SIGNING THIS AGREEMENT ARE:
(Give full legal name. If you are a respondent, state your relationship to the child(ren). If you are an employee of the children’s aid
society, state your position within the society.)
Print or type full legal name
Relationship to child OR position within children’s aid society
Signature
Date of signature
Print or type full legal name
Relationship to child OR position within children’s aid society
Signature
Date of signature
Print or type full legal name
Relationship to child OR position within children’s aid society
Signature
Date of signature
WE AGREE:
(a) that the statements made on this form are true; and
(b) that this form may be filed with the court and may be read to the court as evidence, without
affecting anyone’s right to test that evidence by cross-examination or to bring in other evidence.
FLR-33D-E (2005/09)
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