FLR-CFSA-1-E (2016/11) Page 1 of 1
ONTARIOCourt File Number
(Name of Court)
at(Municipality)
CFSA Endorsement Sheet
Date Applicant(s): Present
Counsel: Present
Duty Counsel
Respondent(s): Present
Counsel: Present
Duty Counsel
Order to go in accordance with minutes of settlement or consent
filed.
Name of Child: Date of Birth:
Date Into Care:
Date of Protection Finding (within three (3) months):
Date of Status Review Application:Date of Disposition:
Date of s.54:
Name of Child: Date of Birth:
Date Into Care:
Date of Protection Finding (within three (3) months):
Date of Status Review Application:Date of Disposition:
Date of s.54:
Name of Child: Date of Birth:
Date Into Care:
Date of Protection Finding (within three (3) months):
Date of Status Review Application:Date of Disposition:
Date of s.54:
Service Completed On:
Service Dispensed with on:
Noted in Default:
Service on Band (date):
Family Group Conferencing/Mediation (i.e. looking for kin):
Yes No
Form 23: Summons to Witness�
FLR-CFSA-1-E (2016/11)
Disponible en français
Page of
Form 23: Summons to
Witness
(page )
Page of
Form 4: Notice of Change in
Representation
Page
FLR-CFSA-1-E (2016/11)
ONTARIO
Form 23: Summons to Witness
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at
CFSA Endorsement Sheet
Name of Child:
Date of Birth:
Date Into Care:
Date of Protection Finding (within three (3) months):
Date of Status Review Application:
Date of Disposition:
Date of s.54:
Name of Child:
Date of Birth:
Date Into Care:
Date of Protection Finding (within three (3) months):
Date of Status Review Application:
Date of Disposition:
Date of s.54:
Name of Child:
Date of Birth:
Date Into Care:
Date of Protection Finding (within three (3) months):
Date of Status Review Application:
Date of Disposition:
Date of s.54:
Service Completed On:
Service Dispensed with on:
Noted in Default:
Service on Band (date):
Family Group Conferencing/Mediation (i.e. looking for kin):
Yes
No
8.0.1291.1.339988.308172
CFSA Endorsement Sheet
CFSA Endorsement Sheet
CurrentPageNumber: NumberofPages: TextField: Court File Number:
TextField1: Application type: Municipality: Date : TO: (full legal
name of witness): Order to go in accordance with minutes of
settlement or consent filed.: 0Clear Form: Print Form:
