Legal Aid Queensland application form (LAQAPP) Completed Form Examples and Samples

Client: Ms. Eleanor Vance (DOB: 15/07/1988)

Consultation Date: 12/03/2026

Notes from today's meeting with Ms. Vance indicate she is seeking urgent legal aid for a family law matter. Eleanor identifies as a female and an Aboriginal woman. She mentioned she has never used other names. She is currently separated from her de facto partner, Mark Stevens, with whom she has two children: Lily (born 03/11/2018) and Tom (born 20/01/2021). She confirmed she doesn't need an interpreter and has no disabilities affecting access to services, but due to recent events, she is experiencing significant stress and is unable to work.

Her home address is Unit 4, 12 Acacia Street, West End, QLD 4101. Due to concerns for her safety from Mark, she requested that all correspondence be sent to the CLC office, not her home address. Her mobile number is 0412 345 678, and her email is [email protected]. She is not in prison.

Financially, Eleanor is currently not working and receives a full Single Parenting Payment from Centrelink. Her Centrelink card number is 1234567890123456, expiring 10/2028. She has attached her Centrelink income statement and 3 months of bank statements from Commonwealth Bank, showing a current balance of approximately $500. She lives alone with her children (single – not working). No one else provides financial help. She does not own a home or any other real estate. She drives a 2015 Mazda 3, which she values at $13,000 but still owes $8,000 on the loan, giving her $5,000 equity. She has no other valuable assets or self-employment income.

The primary legal problems are securing a Domestic Violence Protection Order (DVPO) against Mark and establishing Parenting Orders. The police applied for a DVPO on her behalf following an incident on 05/03/2026, where Mark became physically aggressive. She wants aid for applying for a protection order and also for a property settlement which includes their joint bank accounts and the Mazda 3. She separated from Mark on 01/03/2026 after a five-year de facto relationship that commenced on 01/03/2021. She has a court mention scheduled for the police-applied DVPO in the Brisbane Magistrates Court on 25/03/2026 at 9:00 AM. Mark Stevens is currently represented by Sarah Jones from Legal & Co, Level 3, 100 Eagle St, Brisbane QLD 4000. Eleanor attended a Family Dispute Resolution conference last month, but it was unsuccessful; the certificate is attached. There are no other current court orders in place.

Regarding question 18, the legal problem started with escalating verbal abuse from Mark since December 2025, culminating in a physical assault on 05/03/2026. This led to police involvement and her needing to flee with the children, seeking temporary refuge with a friend. She is traumatized and unable to concentrate on work. She needs immediate protection for herself and her children, formal living arrangements, and assistance with property division to ensure financial stability. Lily and Tom both live with Eleanor. She wants Legal Aid Queensland to ensure the children are safe, she has secure housing, and she can access her fair share of any joint assets. She has no other legal matters. She understands the declaration and consents to the release of any QP9 or criminal history to Legal Aid Queensland. She confirms she will send photocopies of all documents and has answered all questions. Her signature will be provided on page 14.