Statement Of Agreed Facts Page 3
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3Form 33D: Statement of Agreed Facts
(page 3)
Court file number
(Status Review)
2.
The most recent protection order dealing with the child(ren) in paragraph 1 was made on (date)
and it said that: (State substance of order.)
3.
Since the order under review was made, the following person(s) has/have become a “parent” under Part III of the Child and
Family Services Act:
Full legal name
Relationship to child
4.
Since that order was made, the following important events have happened:
(Describe only the events on which you can ALL agree. Please remember that this is a statement of AGREED FACTS. That
means that you must not set out something as a fact if at least one of the persons signing this statement disagrees with it. If you
cannot agree at all about anything, write: “No agreement reached.”)
5.
We agree that an order of the court is needed now and that it would best serve the best interests of the child(ren)
because:
(If there is no agreement that an order needs to be made, write: “No agreement reached on need for an order.” If you agree
that an order needs to be made, give reasons for it and set out its terms and conditions. If any person disagrees with a reason,
term or condition, then you must not include that reason, term or condition. If you cannot agree on any reasons, write: “No
agreement reached on reasons for order.” If you cannot agree on any terms or conditions of the order, write: “No agreement
reached on terms and conditions of order.”)
Put a line through any blank space left on this page.
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FLR-33D-E (2005/09)
Page 3 of 3
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