Act of Sederunt (Child Care and Maintenance Rules) 1997 No. 291 (S. 19)

SCHEDULE S

Rule 2.44(7)

FORM 21 S FORM OF DISCHARGE OR VARIATION OF PARENTAL RESPONSIBILITIES ORDER UNDER SECTION 86 (5) OF THE CHILDREN (SCOTLAND) ACT 1995

To :

(Full name and address of person to whom intimation of the order is to be sent) [N.B. See Rule 2.44(7)]

In the application for *Variation/Discharge of Parental Responsibilities Order in relation to the child (full name and date of birth of child as given in the birth certificate)

At (Name of Sheriff Court) on(date of Order), The Sheriff

(1) Discharged the Parental Responsibilities Order dated(insert date of original Order)

or

(2) Varied the Parental Responsibilities Order dated (insert date of original Order) by (insert details of variation)

Signature....................

Designation

Date

*delete as appropriate