FORM 70.08A

No.

IN THE SUPREME COURT OF NOVA SCOTIA

(FAMILY DIVISION)

BETWEEN:

*[A. B.]

- and -

*[C. B.]

Applicant/Petitioner

Respondent

PARENTING STATEMENT

Please Check the Box that Applies to You:

☐ I am the Applicant (the person making an application)

☐ I am the Respondent (the person responding to an application)

This matter relates to the following child or children:

Full Name (Including Middle Name) Age Birthdate (M/D/Y)

1) __________________________________________________________________________

2) __________________________________________________________________________

3) __________________________________________________________________________

4) __________________________________________________________________________

The child or children receive child care or attend pre-school or school as follows:

Child’s Name Days Hours Location

____________________________________________________________________________

__________________________________________________________________________________________

The following child or children have special needs or disabilities that may affect custody, access or parenting arrangements:

Child’s Name Special Needs or Disabilities Details

____________________________________________________________________________

The present parenting arrangements for each child:

a) Where does each child live now?

______________________________________________________________________

b) What are the visiting arrangements for each child now?

______________________________________________________________________

The proposed parenting arrangements for each child:

a) Where do you want each child to live?

______________________________________________________________________

b) What visiting arrangements do you want for each child?

☐ Reasonable access (flexible visiting rights that you both agree to) ________________________________________________________________

________________________________________________________________

☐ Specified access (if so, give specific details including dates, times, conditions):

________________________________________________________________

☐ Supervised access (visiting that takes place with another adult present), if so, give specific details (who would supervise/ where and when):

________________________________________________________________

☐ Other terms/conditions that you would like the Court to order related to access:

________________________________________________________________

Do you or the other parent work outside the home, if so what are the days and hours of work?

____________________________________________________________________________

I DECLARE THAT THE ABOVE INFORMATION IS ACCURATE TO THE BEST OF MY KNOWLEDGE. (You are advised to seek legal advice if you need help in completing this form.)

_____________________________ ________________________________

Date Signature

________________________________

Full Name (Please Print)