Form 15a - Change Information Form

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ONTARIO
Court file number
(Name of Court)
Form 15A: Change
at
Information Form
Court office address
Applicant(s)
Full legal name & address for service — street & number, municipality,
Lawyer’s name & address — street & number, municipality, postal code,
postal code, telephone & fax numbers and e-mail address (if any).
telephone & fax numbers and e-mail address (if any).
Respondent(s)
Full legal name & address for service — street & number, municipality,
Lawyer’s name & address — street & number, municipality, postal code,
postal code, telephone & fax numbers and e-mail address (if any).
telephone & fax numbers and e-mail address (if any).
Assignee (if applicable)
Full legal name & address for service — street & number, municipality,
Lawyer’s name & address — street & number, municipality, postal code,
postal code, telephone & fax numbers and e-mail address (if any).
telephone & fax numbers and e-mail address (if any).
PART 1 – GENERAL INFORMATION
(This part should be filled out to the best ability of the party asking for a change in an order or support agreement.)
My name is
(full legal name)
I live in
(municipality & province)
Sworn/Affirmed
and I
that the following is true:
applicant
respondent
1. I am the
2. The applicant,
(applicant’s full legal name)
was born on
(date of birth)
lives in
(municipality & province)
married
living in a spousal relationship
and, at the present time, is
separated
other
)
(specify
support recipient
support payor
The applicant is the
3. The respondent,
(respondent’s full legal name)
was born on
(date of birth)
lives in
(municipality & province)
married
living in a spousal relationship
and, at the present time, is
separated
other (specify)
support recipient
support payor
The respondent is the
FLR-15A-E (2016/04)
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