Circuit Court Forms

FORM 37R

AN CHÚIRT CHUARDA TEAGHLAIGH

THE CIRCUIT FAMILY COURT

      CIRCUIT                                                                    COUNTY OF

IN THE MATTER OF THE GENDER RECOGNITION ACT 2015

AFFIDAVIT OF [Insert name of person swearing affidavit]

I, [Insert name of person swearing affidavit], of ........ being aged eighteen years and upwards, MAKE OATH and say as follows:

1. I am *[one of the parents] *[the surviving parent] *[the surviving guardian] of [state name of child on whose behalf the application is made] (“the child”), who ordinarily resides at ........

2. I refer to the application of (state name of next friend of child on whose behalf the application is made) as next friend of the child to the Court under section 12 of the above Act for an order exempting the child from the requirements of *[section 9(2)(a)][1] *[section 15(8)(b)][2] of the Act.

3. I consent to that application being made.

.......... Deponent

Sworn before me at ..........

in the County of ............ this ... day of ......... 20 ...

and *[I know the deponent personally]

*[the deponent having been identified to me by ...... of ........ who is personally known to me]

*[the identity of the deponent having been established by me by reference to the following document (being a relevant document within the meaning of section 2 of the Statutory Declarations Act 1938), viz ..........]

..........................................................

Commissioner for Oaths/Practising Solicitor

1 To be completed where the child intends to apply to the Minister for a gender recognition certificate.
2 To be completed where the child intends to apply to the Minister for revocation of a gender recognition certificate.