SUPREME[i] COURT OF QUEENSLAND

REGISTRY:

NUMBER:

Plaintiff2:(As per Claim)

AND

[First] Defendant3(As per Claim)

AND

[Second Defendant](As per Claim)

STATEMENT SUPPORTING APPLICATION FOR

ENFORCEMENT WARRANT

Enforcement Creditor: (Name)

Enforcement Debtor: (Name)

(Full name of deponent)of (Residential or business address, or place of employment),(Occupation or other description) states on oath [or solemnly and sincerely affirms and declares]:

1. I am the enforcement creditor (or the enforcement creditors solicitor or agent)

2. The enforcement creditor obtained a money order against the enforcement debtor in the Court on (date) for an amount of $ .

3. The date and amount of each payment made under the order are (detail of payments, if any)

4. The costs incurred in previous enforcement proceedings in relation to the order debt are as follows:

5. The interest (if any) due at the date of swearing this statement is $ .

6. (Insert any other details that are necessary to calculate the amount payable under the order at the date of swearing this statement and how the amount is calculated.

7. The daily amount of interest (if any) that, subject to any future payment under the order, will accrue after the date of swearing this statement is $ .

8.(Insert any other information necessary in respect of the orders being sought)

Sworn [or: Affirmed] by (full name of deponent)at (place) on (date)in the presence of:

(Signed by deponent)(Signed by the person taking affidavit)

Deponent(Statement of capacity to take affidavit)[i]

NOTE

This statement must be sworn not earlier than 2 business days before the date of the application for the enforcement warrant (R.817)

[i] For example, “solicitor”, “barrister”, “Justice of the Peace”

[i].For an application in the District Court or a Magistrates Court, substitute “District Court” or “Magistrates Courts” respectively.

2For proceedings commenced by Originating Application for “Plaintiff” substitute “Applicant”

3For proceedings commenced by Originating Application for “Defendant” substitute “Respondent”