This form contains 487 fields organized into 120 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Aboriginal or Torres Strait Islander Identification
No	Checkbox	Check this box if you do not identify as Aboriginal or Torres Strait Islander.
Yes, Aboriginal	Checkbox	Check this box if you identify as Aboriginal (but not Torres Strait Islander).
Yes, Torres Strait Islander	Checkbox	Check this box if you identify as Torres Strait Islander (but not Aboriginal).
Additional Details (Large Text Box)
Additional details	Text	Enter any extra information about your family or relationship problem (for example timelines, names, dates, relevant events, and any other details you want the reviewer to know). Max length: 38 characters
Age eligibility (17 years or younger)
Are you 17 years or younger? No	Checkbox	Check this box if you are NOT 17 years old or younger (i.e., you are 18 or older).
Are you 17 years or younger? Yes	Checkbox	Check this box if you ARE 17 years old or younger.
Applicant Name (Family, First, Middle)
Family name (surname)	Text	Enter your family name or surname exactly as it appears on your official documents. Max length: 48 characters
First name (given name)	Text	Enter your primary given name (first name) exactly as it appears on your official documents. Max length: 48 characters
Middle name(s)	Text	Enter any middle name(s) you use, separated by spaces, or leave blank if you have none. Max length: 51 characters
Apply for Bail (If in Custody)?
If you are in custody, do you want to apply for bail? — No	Checkbox	Check this box if the person is currently in custody and does NOT want to apply for bail.
If you are in custody, do you want to apply for bail? — Yes	Checkbox	Check this box if the person is currently in custody and DOES want to apply for bail.
Authority to complete application for someone else (checkbox and authority details)
No — What authority do you have to complete this application for someone else?	Checkbox	Check this box when you are NOT completing the application for yourself and must provide the authority you have (for example, power of attorney, QCAT order, parent or guardian).
Authority to act (describe)	Text	Enter the authority you have to complete this application for someone else (for example: power of attorney, QCAT order, parent, guardian), providing enough detail to identify the legal basis for acting on their behalf. Fill only if 'No — Authority to complete application for someone else' is 'Yes'. Max length: 47 characters Depends on: No — Authority to complete application for someone else
Authority to release information consent (name, QPS brief history choice, signature, date)
Authorised person name	Text	Enter the full name of the applicant or the authorised person giving consent for Police Prosecutions to release information to Legal Aid Queensland. Max length: 44 characters
Consent to release QP9 / criminal & traffic history — No	Checkbox	Check this box if you do NOT consent to Police Prosecutions providing Legal Aid Queensland with a copy of your Queensland Police Service Court Brief (QP9) and/or your criminal and traffic history.
Consent to release QP9 / criminal & traffic history — Yes	Checkbox	Check this box if you DO consent to Police Prosecutions providing Legal Aid Queensland with a copy of your Queensland Police Service Court Brief (QP9) and/or your criminal and traffic history.
Applicant or authorised person signature	Text	Sign your full name to confirm you authorise the release of information and accept the declaration and authority statements on this form. Max length: 41 characters
Signature date	Date	Provide the date when the applicant or authorised person signed this declaration. Max length: 25 characters
Birth Date
Birth date	Date	Enter your date of birth for the person to whom this form pertains. Max length: 25 characters
Born in Another Country (No/Yes) and Country
Born in Another Country - No	Checkbox	Check this box if you were not born in another country (i.e., you were born in this country).
Born in Another Country - Yes	Checkbox	Check this box if you were born in another country (not in this country).
Born in Another Country - Which country?	Checkbox	If you checked Yes, enter the name of the country where you were born in the adjacent text box.
Country of birth	Text	Enter the name of the country where you were born (provide the full country name). Fill only if 'Born in Another Country - Yes' is 'Yes'. Max length: 57 characters Depends on: Born in Another Country - Yes
Centrelink/Veterans payment received (Q5)
Q5 - No (Go to question 6)	Checkbox	Check this box if neither you nor the person who helps you financially receives a Centrelink or Veterans' Affairs payment; if checked, skip to question 6.
Q5 - Yes (Which payment?)	Checkbox	Check this box if you or the person who helps you financially receives a Centrelink or Veterans' Affairs payment; if checked, provide details of which payment(s) follow‑up fields request.
Checklist - Court Details Attachments
Copies of any court documents you have received/filed	Checkbox	Check this box if you have attached photocopies of any court documents you have received or filed to your application.
Checklist - Criminal Law Problem Documents
Queensland Police Service Court Brief (QP9), criminal and traffic history, notice to appear, proceeds of crime order	Checkbox	Check this box when you have attached the Queensland Police Service Court Brief (QP9) and any criminal/traffic history, notice to appear, or proceeds of crime order related to your criminal law problem.
Checklist - Family or Relationship Problem Documents
Any court orders, family dispute resolution certificate(s), or invitation to family dispute resolution conference	Checkbox	Check this box if you have attached any court orders, family dispute resolution certificate(s), or an invitation to attend a family dispute resolution conference to your application.
Checklist - Final Review Confirmations
Answered all relevant questions including question 18 (page 13)	Checkbox	Check this box after you have completed and answered every relevant question on the form, including question 18 on page 13.
Read and signed the 'Declaration and authority to release information' (page 14)	Checkbox	Check this box once you have read and signed the Declaration and Authority to Release Information on page 14.
Checklist - Financial Details Attachments
Centrelink income statement	Checkbox	Check this box if you are attaching a Centrelink income statement with your application.
Payslips for at least the last four weeks	Checkbox	Check this box if you are attaching payslips covering at least the last four weeks or a letter from your employer confirming your income.
Copies of bank statements for the past three months	Checkbox	Check this box if you are attaching copies of bank statements for the past three months from all financial institutions where you have accounts.
Proof of your self‑employed income	Checkbox	Check this box if you are attaching documentation that verifies your self‑employed income.
Child Details - Fifth Child
Fifth child's family name	Text	Enter the fifth child's family (last) name as it appears on legal or official documents. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 14 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Fifth child's first and middle name(s)	Text	Enter the fifth child's given first name and any middle name(s). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 25 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Fifth child's birth date	Date	Enter the fifth child's date of birth. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 8 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Fifth child's relationship to you	Text	State how the fifth child is related to you (for example: son, daughter, stepchild, foster child). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 12 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Fifth child's involvement in this matter	Text	Indicate whether the fifth child is involved in this matter and give brief details of that involvement if applicable. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 8 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Fifth child's who they live with	Text	Provide the name(s) or description of the person(s) or household the fifth child normally lives with (for example: mother, father, both parents, guardian). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 13 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Child Details - First Child
First child's family name	Text	Enter the family (last) name of your first child. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 14 characters Depends on: Q16 — Yes (Do you have any children under 18?)
First child's first and middle name(s)	Text	Enter the first name and any middle name(s) of your first child. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 25 characters Depends on: Q16 — Yes (Do you have any children under 18?)
First child's birth date	Date	Enter the birth date of your first child. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 8 characters Depends on: Q16 — Yes (Do you have any children under 18?)
First child's relationship to you	Text	Describe how this child is related to you (for example, 'son', 'daughter', 'stepchild', or 'grandchild'). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 11 characters Depends on: Q16 — Yes (Do you have any children under 18?)
First child's living arrangements	Text	Enter the name(s) or relationship(s) of the person(s) the child lives with (for example, 'mother', 'father', 'grandparents' or specific names). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 11 characters Depends on: Q16 — Yes (Do you have any children under 18?)
First child's involvement in this matter	Text	Indicate whether, and briefly how, the child is involved in this matter (for example, 'yes', 'no', or a short explanation). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 8 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Child Details - Fourth Child
Fourth child — Family name	Text	Enter the fourth child's family (last) name as it appears on official documents. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 12 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Fourth child — First and middle name(s)	Text	Enter the fourth child's first name and any middle name(s). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 25 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Fourth child — Birth date	Date	Enter the fourth child's date of birth. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 9 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Fourth child — Relationship to you	Text	Describe how the fourth child is related to you (for example: son, daughter, stepchild or foster child). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 12 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Fourth child — Who do they live with?	Text	Provide the name(s) or relationship(s) of the person(s) the fourth child lives with (for example: mother, father, both parents, guardian). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 12 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Fourth child — Involved in this matter?	Text	State whether the fourth child is involved in this matter and, if applicable, give a brief explanation of their involvement. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 9 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Child Details - Second Child
Second child's family name	Text	Enter the second child's family (surname/last) name. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 14 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Second child's first and middle name(s)	Text	Enter the second child's given name and any middle name(s). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 23 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Second child's birth date	Date	Enter the second child's date of birth. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 8 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Second child's relationship to you	Text	Specify how the second child is related to you (for example: son, daughter, stepchild, foster child). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 10 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Who the second child lives with	Text	Provide the name(s) or relationship(s) of the person(s) the second child lives with (for example: mother, father, guardian, 'lives alone'). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 10 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Is the second child involved in this matter?	Text	Indicate whether and how the second child is involved in this matter (for example: 'Yes - witness', 'No', or brief details). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 8 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Child Details - Third Child
Third child's family name	Text	Enter the child's family name (surname/last name). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 14 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Third child's first and middle name(s)	Text	Enter the child's given first name and any middle name(s). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 23 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Third child's relationship to you	Text	State how the child is related to you (for example 'son', 'daughter', 'stepchild' or other relationship). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 10 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Who the third child lives with	Text	Enter the name(s) or relationship(s) of the person(s) the child lives with (for example 'mother', 'father', 'grandparent' or specific names). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 11 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Third child's involvement in this matter	Text	Indicate whether the child is involved in this matter and briefly describe how (for example 'No' or 'Yes - witness/subject'). Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 8 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Third child's birth date	Date	Enter the child's date of birth. Fill only if 'Q16 — Yes (Do you have any children under 18?)' is 'Yes'. Max length: 9 characters Depends on: Q16 — Yes (Do you have any children under 18?)
Children Under 18 (Q16) - Yes/No
Q16 — No (Do you have any children under 18?)	Checkbox	Check this box if you do NOT have any children under 18.
Q16 — Yes (Do you have any children under 18?)	Checkbox	Check this box if you DO have one or more children under 18 (then provide their details in the table).
Complainant details (who made the complaint) and extra details flag
Complainant family name	Text	Enter the family or last name of the person who made the complaint against you. Fill only if 'Not sure' is 'No'. Max length: 60 characters Depends on: Not sure
Complainant first name	Text	Enter the given or first name of the person who made the complaint against you. Fill only if 'Not sure' is 'No'. Max length: 60 characters Depends on: Not sure
Not sure	Checkbox	Check this box if you do not know or cannot identify who made the complaint against you.
List extra details at question 18	Checkbox	Check this box to indicate that additional details about the complainant(s) have been listed at question 18.
Completing application for yourself (Yes/No)
Yes — Read and sign declaration below	Checkbox	Check this box if you are completing this application for yourself; you must read and sign the declaration below.
No — Authority to complete application for someone else	Checkbox	Check this box if you are NOT completing the application for yourself and you must provide the authority you have (for example power of attorney, QCAT order, parent or guardian).
Contact details (phone and email)
Home phone (area/country code)	Text	Enter the home telephone country or area code (for example +44 or 02), or leave blank if not applicable. Max length: 7 characters
Home phone (number)	Text	Enter the remainder of your home telephone number (the local number part) without the area code. Max length: 45 characters
Mobile phone	Text	Enter your full mobile phone number, including country code if applicable. Max length: 54 characters
Work phone (area/country code)	Text	Enter the work telephone country or area code, or leave blank if not applicable. Max length: 7 characters
Work phone (number)	Text	Enter the remainder of your work telephone number (the local number part) without the area code. Max length: 48 characters
Email	Text	Enter your primary email address for contact. Max length: 58 characters
Other contact	Text	Enter any other contact detail (for example an alternative phone number, fax number, or secondary email) or leave blank if none. Max length: 58 characters
Counselling/Mediation/Dispute Resolution Sessions
Counselling/Mediation/Dispute Resolution Sessions – No	Checkbox	Check this box if you have NOT attended any counselling, mediation or family dispute resolution sessions with the person you are in dispute with.
Counselling/Mediation/Dispute Resolution Sessions – Yes	Checkbox	Check this box if you HAVE attended counselling, mediation or family dispute resolution sessions with the person you are in dispute with (and attach any certificates received from these sessions).
Counselling/mediation session details	Text	Enter details of any counselling, mediation or family dispute resolution sessions you attended with the person you are in dispute with, including provider/organisation names, dates, purpose and any outcomes or certificates received. Fill only if 'Counselling/Mediation/Dispute Resolution Sessions – Yes' is 'Yes'. Max length: 26 characters Depends on: Counselling/Mediation/Dispute Resolution Sessions – Yes
Court or tribunal required (Yes/No, date, time)
Do you have to go to court or a tribunal? — No	Checkbox	Check this box if you do NOT have to go to any court or tribunal in relation to this matter.
Do you have to go to court or a tribunal? — Yes	Checkbox	Check this box if you DO have to attend a court or tribunal, and provide the date, time and any court documents if known.
Court/tribunal date	Date	Enter the date of the court or tribunal hearing or appearance, if known. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Max length: 25 characters Depends on: Do you have to go to court or a tribunal? — Yes
Court/tribunal time	Time	Enter the time of the court or tribunal hearing or appearance. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Max length: 23 characters Depends on: Do you have to go to court or a tribunal? — Yes
Court or tribunal suburb/town
Suburb/town (court or tribunal)	Text	Enter the name of the suburb or town where the court or tribunal hearing will take place. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Max length: 59 characters Depends on: Do you have to go to court or a tribunal? — Yes
Criminal Record Declaration
No	Checkbox	Check this box if you do not have a criminal record.
Not sure	Checkbox	Check this box if you are unsure whether you have a criminal record.
Yes	Checkbox	Check this box if you do have a criminal record.
Attach or list criminal record	Checkbox	Check this box if you are attaching a copy of your criminal record or listing your criminal record on this form (include matters where no conviction was recorded).
Criminal Record List - First Entry
First entry - Year	Text	Enter the year when the recorded offence occurred for the first listed criminal record entry. Fill only if 'Yes' is 'Yes'. Max length: 8 characters Depends on: Yes
First entry - Offence	Text	Describe the offence for the first listed criminal record entry (brief name or description of the charge). Fill only if 'Yes' is 'Yes'. Max length: 40 characters Depends on: Yes
First entry - Penalty	Text	Provide the penalty, sentence or outcome imposed for the offence in the first listed criminal record entry. Fill only if 'Yes' is 'Yes'. Max length: 40 characters Depends on: Yes
Criminal Record List - Fourth Entry
Fourth entry — Year	Text	Enter the year when this offence occurred (four-digit year). Fill only if 'Yes' is 'Yes'. Max length: 8 characters Depends on: Yes
Fourth entry — Offence	Text	Describe the offence or charge for this entry using a brief clear phrase (e.g., 'shoplifting', 'drink driving'). Fill only if 'Yes' is 'Yes'. Max length: 40 characters Depends on: Yes
Fourth entry — Penalty	Text	Enter the penalty, sentence or outcome imposed for this offence (for example: fine amount, community service, imprisonment, discharged, or 'no conviction recorded'). Fill only if 'Yes' is 'Yes'. Max length: 40 characters Depends on: Yes
Criminal Record List - Second Entry
Second entry - Year	Number	Enter the year of the offence for the second criminal record entry (four-digit year). Fill only if 'Yes' is 'Yes'. Max length: 8 characters Depends on: Yes
Second entry - Offence	Text	Enter a brief description of the offence for the second criminal record entry. Fill only if 'Yes' is 'Yes'. Max length: 36 characters Depends on: Yes
Second entry - Penalty	Text	Enter the penalty, sentence or outcome imposed for the offence in the second criminal record entry. Fill only if 'Yes' is 'Yes'. Max length: 36 characters Depends on: Yes
Criminal Record List - Third Entry
Third entry — Year	Number	Enter the year when the offence occurred for the third listed criminal record entry. Fill only if 'Yes' is 'Yes'. Max length: 9 characters Depends on: Yes
Third entry — Offence	Text	Provide the name or short description of the offence for the third listed criminal record entry. Fill only if 'Yes' is 'Yes'. Max length: 40 characters Depends on: Yes
Third entry — Penalty	Text	Enter the penalty, sentence or outcome imposed for the offence in the third listed criminal record entry. Fill only if 'Yes' is 'Yes'. Max length: 40 characters Depends on: Yes
De Facto Relationship with the Person in Dispute With
No	Checkbox	Check this box if you were not in a de facto relationship with the person you are in dispute with.
Yes	Checkbox	Check this box if you were in a de facto relationship with the person you are in dispute with.
Give details	Checkbox	Check this box to indicate you will provide details about the de facto relationship (for example relationship date, separation date) when the 'Yes' option applies.
De facto relationship — Relationship date	Date	Enter the date when your de facto relationship with the person in dispute began. Fill only if 'Yes' is 'Yes'. Max length: 25 characters Depends on: Yes
De facto relationship — Separation date	Date	Enter the date when you and the person in dispute separated or ended the de facto relationship. Fill only if 'Yes' is 'Yes'. Max length: 23 characters Depends on: Yes
Declaration acknowledgment and signature (read/sign, signed, date)
Yes — Read and sign declaration below	Checkbox	Check this box if you are completing this application for yourself and will read and sign the declaration below.
Declaration - Signature	Text	Enter the signature (your full name or legal signature) to confirm you have read, understood and accept the declaration and conflict of interest/privacy statement. Max length: 47 characters
Declaration - Date Signed	Date	Enter the date on which you signed the declaration. Max length: 25 characters
Disability Affecting Access (No/Yes) and Disability Type/Details
No	Checkbox	Check this box if you do NOT have a disability that affects how you access our services.
Yes	Checkbox	Check this box if you DO have a disability that affects how you access our services.
Intellectual	Checkbox	Check this box if the disability that affects your access is an intellectual disability.
Psychological/psychiatric	Checkbox	Check this box if the disability that affects your access is psychological or psychiatric in nature.
Sensory (including speech)	Checkbox	Check this box if the disability that affects your access is sensory (including speech-related) such as hearing or vision issues.
Physical	Checkbox	Check this box if the disability that affects your access is physical, and provide further details in the space provided.
Disability details (physical / access needs)	Text	Enter a short description of the disability and how it affects access to services, including the nature of the condition, any physical limitations and any specific adjustments or aids required. Fill only if 'Physical' is selected. Max length: 57 characters Depends on: Physical
Domestic/family violence matter type
Applying for a protection order	Checkbox	Check this box if you are the person seeking to apply for a protection order because of domestic or family violence. Fill only if 'Domestic/family violence' is 'Yes'. Depends on: Domestic/family violence
Responding to a protection order application	Checkbox	Check this box if you are responding to or defending against someone else's protection order application related to domestic or family violence. Fill only if 'Domestic/family violence' is 'Yes'. Depends on: Domestic/family violence
Change of family court orders due to violence	Checkbox	Check this box if you are asking for existing family court orders to be changed because of domestic or family violence concerns. Fill only if 'Domestic/family violence' is 'Yes'. Depends on: Domestic/family violence
Extra Details (Q18 reference)
List extra details at question 18	Checkbox	Check this box when you need to provide additional information referenced in question 18 (i.e., you have extra details to list about the children or circumstances described).
Extra or Practical Help Needed (No/Yes) and Details
Do you need extra or practical help — No	Checkbox	Check this box if you do not need any extra or practical help to access services (for example, you do not need help to read or write).
Do you need extra or practical help — Yes	Checkbox	Check this box if you do need extra or practical help to access services (for example, you need help to read, write, or otherwise access the form or service).
Do you need extra or practical help — Give details	Checkbox	Check this box when you have indicated 'Yes' and want to provide details about the extra or practical help you need, then fill in the details in the adjacent text field.
Extra or practical help — details	Text	If you answered Yes to needing extra or practical help to access services, describe the specific help you need (for example, help to read or write, mobility assistance, or other practical support). Fill only if 'Do you need extra or practical help — Yes' is 'Yes'. Max length: 57 characters Depends on: Do you need extra or practical help — Yes
Financial help from another person (Q4)
Q4 No	Checkbox	Check this box if you do not get any financial help from another person (you do not regularly receive money, bill payments, or shared living expenses from a relative, partner or other person).
Q4 Yes	Checkbox	Check this box if you do get financial help from another person (for example a relative or partner regularly gives you money, helps pay your bills or shares living expenses).
First person charged - Has a lawyer? (Yes/No/Don't know)
First person charged - No	Checkbox	Check this box if the first person charged does not have a lawyer.
First person charged - Yes	Checkbox	Check this box if the first person charged does have a lawyer (then give the lawyer's details below if known).
First person charged - Don't know	Checkbox	Check this box if you do not know whether the first person charged has a lawyer.
First person charged - Lawyer details
First person charged — Lawyer's name	Text	Enter the full name of the lawyer representing the first person charged. Fill only if 'Yes', 'First person charged - Yes' is 'Yes' (all). Max length: 57 characters Depends on: Yes, First person charged - Yes
First person charged — Law firm	Text	Enter the name of the law firm or legal practice that represents the first person charged. Fill only if 'Yes', 'First person charged - Yes' is 'Yes' (all). Max length: 57 characters Depends on: Yes, First person charged - Yes
First person charged — Lawyer's address	Text	Enter the lawyer's street or postal address where correspondence can be sent. Fill only if 'Yes', 'First person charged - Yes' is 'Yes' (all). Max length: 57 characters Depends on: Yes, First person charged - Yes
First person charged — Lawyer's suburb/town	Text	Enter the suburb or town for the lawyer's address. Fill only if 'Yes', 'First person charged - Yes' is 'Yes' (all). Max length: 62 characters Depends on: Yes, First person charged - Yes
First person charged — Lawyer's state	Text	Enter the state or territory for the lawyer's address. Fill only if 'Yes', 'First person charged - Yes' is 'Yes' (all). Max length: 16 characters Depends on: Yes, First person charged - Yes
First person charged — Lawyer's postcode	Number	Enter the postcode for the lawyer's address. Fill only if 'Yes', 'First person charged - Yes' is 'Yes' (all). Max length: 28 characters Depends on: Yes, First person charged - Yes
First person charged - Personal and address details
First person charged — Family name	Text	Enter the family (last) name of the first person charged. Fill only if 'Yes' is 'Yes'. Max length: 57 characters Depends on: Yes
First person charged — First name	Text	Enter the given (first) name of the first person charged. Fill only if 'Yes' is 'Yes'. Max length: 57 characters Depends on: Yes
First person charged — Middle name(s)	Text	Enter any middle name(s) of the first person charged; leave blank if none. Fill only if 'Yes' is 'Yes'. Max length: 57 characters Depends on: Yes
First person charged — Street address	Text	Enter the full street address (street number and name) of the first person charged. Fill only if 'Yes' is 'Yes'. Max length: 57 characters Depends on: Yes
First person charged — Suburb/Town	Text	Enter the suburb or town for the first person charged's address. Fill only if 'Yes' is 'Yes'. Max length: 57 characters Depends on: Yes
First person charged — State	Text	Enter the state or territory for the first person charged's address. Fill only if 'Yes' is 'Yes'. Max length: 16 characters Depends on: Yes
First person charged — Postcode	Text	Enter the postcode (ZIP/postal code) for the first person charged's address. Fill only if 'Yes' is 'Yes'. Max length: 27 characters Depends on: Yes
First person charged — Birth date	Date	Enter the date of birth of the first person charged. Fill only if 'Yes' is 'Yes'. Max length: 27 characters Depends on: Yes
Further sections (extra details, applicant declaration)
Extra details	Text	Enter any additional information about your legal problem(s) that is not captured elsewhere, such as chronological details, important dates, names of people involved, and other facts that help explain your situation. Max length: 60 characters
Applicant declaration	Text	Provide the applicant's declaration confirming the accuracy of the information given, including any required statement of truth, your full name and the date (and any other text the form asks you to include for the declaration). Max length: 60 characters
Gender (Male/Female/Other) and Details
Male	Checkbox	Check this box if you identify as male.
Female	Checkbox	Check this box if you identify as female.
Other	Checkbox	Check this box if your gender is not male or female, and provide details in the adjacent 'Give details' space.
Gender — Give details (group or organisation)	Text	Enter additional information describing your gender choice, for example the group, organisation, community label or a brief explanatory note. Fill only if 'Other' is 'Other'. Max length: 38 characters Depends on: Other
General
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Health care/pension card additional details
Card details record number	Text	Enter the identifier for this set of current health care or pension card details (for example ‘1’ for the first card entry). Max length: 23 characters
Home address
Home street address	Text	Enter the full street address of your home, including house or unit number and street name. Max length: 54 characters
Home suburb/town	Text	Enter the suburb, town or city where your home is located. Max length: 54 characters
Home state/territory	Text	Enter the state, province or territory for your home address. Max length: 15 characters
Home postcode	Number	Enter the postcode or ZIP code for your home address. Max length: 25 characters
How Do You Want to Plead?
Guilty	Checkbox	Check this box if you wish to enter a plea of guilty to the charge(s).
Not guilty	Checkbox	Check this box if you wish to enter a plea of not guilty to the charge(s).
Not sure	Checkbox	Check this box if you are unsure which plea to enter and have not decided yet.
Interpreter Needed (No/Yes) and Language/Dialect
Interpreter needed - No	Checkbox	Check this box if you do NOT need an interpreter to help you complete this form.
Interpreter needed - Yes	Checkbox	Check this box if you DO need an interpreter to help you complete this form, and then provide the language and dialect in the adjacent field.
Interpreter language and dialect	Text	Enter the language and specific dialect (if applicable) you need an interpreter for to help you complete this form. Fill only if 'Interpreter needed - Yes' is 'Yes'. Max length: 53 characters Depends on: Interpreter needed - Yes
Large Notes/Comments Field
Additional notes / comments	Text	Enter any additional information, explanations or comments relevant to your application or this form; free‑form text for details not captured elsewhere. Max length: 37 characters
Lawyer details (name, firm, address, suburb, state, postcode)
Lawyer's name	Text	Enter the lawyer's full name as you want it recorded (for example, first and last name and any title). Fill only if 'Lawyer representing you - Yes' is 'Yes'. Max length: 53 characters Depends on: Lawyer representing you - Yes
Law firm	Text	Enter the name of the law firm or legal practice representing you. Fill only if 'Lawyer representing you - Yes' is 'Yes'. Max length: 53 characters Depends on: Lawyer representing you - Yes
Address	Text	Enter the lawyer's street address including building number, street name and unit or suite if applicable. Fill only if 'Lawyer representing you - Yes' is 'Yes'. Max length: 58 characters Depends on: Lawyer representing you - Yes
Suburb/town	Text	Enter the suburb or town where the lawyer's office is located. Fill only if 'Lawyer representing you - Yes' is 'Yes'. Max length: 58 characters Depends on: Lawyer representing you - Yes
Postcode	Text	Enter the postcode for the lawyer's office location. Fill only if 'Lawyer representing you - Yes' is 'Yes'. Max length: 32 characters Depends on: Lawyer representing you - Yes
State	Text	Enter the state or territory for the lawyer's office (use the standard abbreviation or full name). Fill only if 'Lawyer representing you - Yes' is 'Yes'. Max length: 10 characters Depends on: Lawyer representing you - Yes
Lawyer representing you (Yes/No + give details indicator)
Lawyer representing you - No	Checkbox	Check this box if you do not have a lawyer representing you.
Lawyer representing you - Yes	Checkbox	Check this box if you have a lawyer representing you.
Lawyer representing you - Give details	Checkbox	Check this box if you have a lawyer and will provide their details in the fields below.
Legal advice / other option and details
Not sure	Checkbox	Check this box if you are unsure whether your application is about a family or relationship problem and you have not decided to request legal advice or provide other details.
Get legal advice	Checkbox	Check this box if you would like to receive legal advice about the family or relationship problem.
Other — details (legal advice)	Text	Enter the text describing the 'Other' option or any additional details about your legal advice request or situation. Fill only if 'Other' is 'Yes'. Max length: 53 characters Depends on: Other
Other	Checkbox	Check this box if none of the other options apply and you want to provide a different response in the adjacent free-text field.
Living and employment situation (Q6)
Couple — one working	Checkbox	Check this box if you live as a couple and only one partner is currently working.
Single — person working	Checkbox	Check this box if you live alone (single) and that person (you) is currently working.
Couple — both working	Checkbox	Check this box if you live as a couple and both partners are currently working.
Single — not working	Checkbox	Check this box if you live alone (single) and are not currently working.
Couple — both not working	Checkbox	Check this box if you live as a couple and neither partner is currently working.
Local Legal Aid Queensland Office Details
Local Office — Box 1	Text	Enter this local Legal Aid Queensland office’s full name, street address and primary contact details (telephone and email); you may also include opening hours or other brief notes. Max length: 8 characters
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Local Office — Box 3	Text	Enter this local Legal Aid Queensland office’s full name, street address and primary contact details (telephone and email); you may also include opening hours or other brief notes. Max length: 9 characters
Local Office — Box 4	Text	Enter this local Legal Aid Queensland office’s full name, street address and primary contact details (telephone and email); you may also include opening hours or other brief notes. Max length: 18 characters
Local Office — Box 5	Text	Enter this local Legal Aid Queensland office’s full name, street address and primary contact details (telephone and email); you may also include opening hours or other brief notes. Max length: 8 characters
Marital Status and Other Details
Married	Checkbox	Check this box if you are currently married (in a legal/registered marriage).
Divorced	Checkbox	Check this box if you are divorced and not currently in a relationship listed on this form.
Defacto	Checkbox	Check this box if you are in a de facto (living together as a couple) relationship.
Single	Checkbox	Check this box if you are single (not married and not in a de facto relationship).
Separated (married/defacto)	Checkbox	Check this box if you are separated from your spouse or de facto partner but not yet divorced.
Other	Checkbox	Check this box if your marital status is not listed among the options above.
Other — Give details	Checkbox	Check this box (and use the adjacent text field) to provide details when you have selected 'Other' as your marital status.
Marital status — Other (details)	Text	If you selected 'Other' for your marital status, enter the specific details or description of your marital situation in this box. Fill only if 'Other' is 'Other'. Max length: 38 characters Depends on: Other
Marriage to the Person in Dispute With
Were you married to the person you are in dispute with? — No	Checkbox	Check this box if you were not married to the person you are in dispute with.
Were you married to the person you are in dispute with? — Yes	Checkbox	Check this box if you were married to the person you are in dispute with.
Were you married to the person you are in dispute with? — Give details	Checkbox	Check this box when you have answered Yes and need to provide marriage details (dates of marriage, separation, divorce) in the fields provided.
Marriage date	Date	Enter the date you were married to the person you are in dispute with. Fill only if 'Were you married to the person you are in dispute with? — Yes' is 'Yes'. Max length: 25 characters Depends on: Were you married to the person you are in dispute with? — Yes
Separation date	Date	Enter the date you and the person in dispute separated. Fill only if 'Were you married to the person you are in dispute with? — Yes' is 'Yes'. Max length: 25 characters Depends on: Were you married to the person you are in dispute with? — Yes
Marriage location	Text	Enter the place or brief detail about the marriage (for example town, state or country) where you and the person were married. Fill only if 'Were you married to the person you are in dispute with? — Yes' is 'Yes'. Max length: 14 characters Depends on: Were you married to the person you are in dispute with? — Yes
Divorce date	Date	Enter the date your marriage to the person in dispute was legally divorced (if applicable). Fill only if 'Were you married to the person you are in dispute with? — Yes' is 'Yes'. Max length: 25 characters Depends on: Were you married to the person you are in dispute with? — Yes
Next court date (details / not sure)
Next court date — purpose	Text	Enter the reason or purpose of the next court date (for example: mention, committal, trial, hearing) to describe what the court appearance is for. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Max length: 74 characters Depends on: Do you have to go to court or a tribunal? — Yes
Not sure (next court date)	Checkbox	Check this box if you do not know what your next court date is for or cannot provide details about the next court appearance (for example mention, committal, trial). Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Number of dependent children under 18
Number of dependent children under 18	Text	Enter the total number of your dependent children under 18 (including any children you pay child support or maintenance for). Max length: 13 characters
Office Use Only - Advised By
Advised by	Text	Enter the full name of the staff member or advisor who provided advice on this application. Fill only if 'No in-house capacity' is 'Yes'. Max length: 64 characters Depends on: No in-house capacity
Office Use Only - Application Handling Staff and Dates
Application taken by	Text	Enter the name (and staff ID if required) of the staff member who took the application. Max length: 44 characters
Application taken date	Date	Enter the date the application was taken. Max length: 23 characters
Application entered by	Text	Enter the name (and staff ID if required) of the staff member who entered the application into the system. Max length: 44 characters
Application entered date	Date	Enter the date the application was entered into the system. Max length: 23 characters
Office use only - Application taken by
Application taken by (staff name)	Text	Enter the full name of the staff member who took or recorded this application. Max length: 42 characters
Office Use Only - Assign to In-house Lawyer
Assign to in-house lawyer	Text	Enter the full name or internal identifier of the in-house lawyer who will be assigned to this application. Fill only if '1 Assign to in-house lawyer' is 'Yes'. Max length: 65 characters Depends on: 1 Assign to in-house lawyer
1 Assign to in-house lawyer	Checkbox	Check this box when, during office processing, the application needs to be assigned to an in‑house lawyer for handling or review.
Office Use Only - Client and File Identifiers
Client ID	Text	Enter the unique identifier assigned to the client (e.g., case or client reference number) exactly as it appears in your records. Max length: 49 characters
File number	Text	Enter the file or matter number for this application (the reference used by your office to track the client's file). Max length: 23 characters
Office use only - Date
Date (office use only)	Date	The date the staff member recorded or processed this application; enter the application processing date. Max length: 26 characters
Date - Day	Checkbox	Tick this box when recording the day (DD) of the date the application was taken (office use only).
Date - Month	Checkbox	Tick this box when recording the month (MM) of the date the application was taken (office use only).
Date - Year	Checkbox	Tick this box when recording the year (YYYY) of the date the application was taken (office use only).
Office Use Only - Supporting Checks
Health care or pension card sighted	Checkbox	Check this box when a staff member has seen and verified the applicant's health care or pension card.
Documents attached	Checkbox	Check this box when the applicant's supporting documents have been received and attached to the application file.
No in-house capacity	Checkbox	Check this box when the office does not have in-house capacity to handle the matter.
Other legal matters (Yes/No/Not sure and details)
Yes (Other legal matters)	Checkbox	Check this box if you ARE involved in one or more other legal matters.
Not sure (Other legal matters)	Checkbox	Check this box if you are UNSURE whether you are involved in any other legal matters.
No (Other legal matters)	Checkbox	Check this box if you are NOT involved in any other legal matters (for example child protection or family law).
Give details (Other legal matters)	Checkbox	Check this box if you will provide further details about the other legal matters in the adjacent details field.
Other legal matters - details	Text	Provide a brief description of any other legal matters you are involved in (for example child protection, family law), including relevant dates or case references if known. Fill only if 'Yes (Other legal matters)' is 'Yes'. Max length: 66 characters Depends on: Yes (Other legal matters)
Other Names Used (No/Yes) and Other Name Details
Other Names Used - No	Checkbox	Check this box if you have never used any other names (for example, maiden name or previous married name).
Other Names Used - Yes	Checkbox	Check this box if you have used other names at any time and will provide those names in the fields below.
Other Names Used - List your other names	Checkbox	Check this box to indicate you will list your other names in the ‘Family name / First name / Type of name’ fields immediately below.
Other family name	Text	Enter the family (surname) you have used previously or additionally (for example a maiden name or former married name). Fill only if 'Other Names Used - Yes' is 'Yes'. Max length: 48 characters Depends on: Other Names Used - Yes
Other first name	Text	Enter the given (first) name you have used previously or additionally. Fill only if 'Other Names Used - Yes' is 'Yes'. Max length: 48 characters Depends on: Other Names Used - Yes
Type of other name	Text	Describe the type or reason for this other name (for example 'maiden name', 'previous married name', 'nickname' or 'legal change'). Fill only if 'Other Names Used - Yes' is 'Yes'. Max length: 48 characters Depends on: Other Names Used - Yes
Other payment details (Q5)
Q5 Other (payment)	Checkbox	Check this box if the Centrelink or Veterans' Affairs payment someone who helps you financially receives is not listed and should be recorded as 'Other'.
Q5 Give details (other payment)	Checkbox	Check this box when you have selected 'Other' and will provide the name/details of that payment in the adjacent text field or attachment.
Q5 Other payment — details	Text	Enter the name or brief description of the other Centrelink or Veterans’ Affairs payment received by the person who helps you financially (e.g. specific allowance or benefit). Fill only if 'Q5 - Yes (Which payment?)', 'Q5 Other (payment)' is 'Yes' for all fields. Max length: 32 characters Depends on: Q5 - Yes (Which payment?), Q5 Other (payment)
Other person's health care/pension card details
Other person's card number	Text	Enter the full health care or pension card number for the other person as shown on their card. Max length: 56 characters
Other person's card expiry date	Date	Enter the expiry date of the other person's health care or pension card. Max length: 14 characters
Other person – Health care	Checkbox	Check this box if the other person holds a Health Care card (enter their card number and expiry date in the fields provided).
Other person – Pension	Checkbox	Check this box if the other person holds a Pension card (enter their card number and expiry date in the fields provided).
Payment amount (Full/Part) (Q5)
Full	Checkbox	Check this box if the person who helps you financially receives a full Centrelink or Veterans' Affairs payment.
Part	Checkbox	Check this box if the person who helps you financially receives a part Centrelink or Veterans' Affairs payment.
Payment type selection (Q5)
Q5 - Disability support pension	Checkbox	Check this box if you or the person who helps you financially receives the Disability Support Pension from Centrelink or Veterans' Affairs.
Q5 - Special benefit	Checkbox	Check this box if you or the person who helps you financially receives a Special Benefit from Centrelink or Veterans' Affairs.
Q5 - Mature age allowance / pension benefit	Checkbox	Check this box if you or the person who helps you financially receives the Mature Age Allowance or a mature age pension benefit from Centrelink or Veterans' Affairs.
Q5 - Veterans and war services	Checkbox	Check this box if you or the person who helps you financially receives Veterans' or war service payments from Centrelink or Veterans' Affairs.
Q5 - Widow allowance	Checkbox	Check this box if you or the person who helps you financially receives the Widow Allowance from Centrelink or Veterans' Affairs.
Q5 - Newstart allowance	Checkbox	Check this box if you or the person who helps you financially receives the Newstart Allowance from Centrelink or Veterans' Affairs.
Q5 - Youth allowance	Checkbox	Check this box if you or the person who helps you financially receives the Youth Allowance from Centrelink or Veterans' Affairs.
Q5 - Parenting payment partnered	Checkbox	Check this box if you or the person who helps you financially receives the Parenting Payment (partnered) from Centrelink or Veterans' Affairs.
Q5 - Sickness allowance	Checkbox	Check this box if you or the person who helps you financially receives the Sickness Allowance from Centrelink or Veterans' Affairs.
Q5 - Single parenting payment	Checkbox	Check this box if you or the person who helps you financially receives the Single Parenting Payment from Centrelink or Veterans' Affairs.
Pleaded Guilty in Court to These Charges?
Have you pleaded guilty in court to these charges? — No	Checkbox	Check this box if you have not pleaded guilty in court to the charges listed.
Have you pleaded guilty in court to these charges? — Yes	Checkbox	Check this box if you have pleaded guilty in court to the charges listed.
Police applied for protection order (Yes/No/When/Not sure)
When police applied for protection order	Date	Enter the date when the police applied for a domestic and family violence protection order about this matter. Fill only if 'Police applied for protection order — Yes (When?)' is 'Yes'. Max length: 27 characters Depends on: Police applied for protection order — Yes (When?)
Police applied for protection order — No	Checkbox	Check this box if the police have not applied for a domestic and family violence protection order about this matter.
Police applied for protection order — Yes (When?)	Checkbox	Check this box if the police have applied for a protection order about this matter, and provide the date in the adjacent day/month/year fields.
Police applied for protection order — Not sure	Checkbox	Check this box if you are unsure whether the police have applied for a domestic and family violence protection order about this matter.
Postal/contact address (if different)
Postal/contact address (street or PO box)	Text	Enter the full postal or contact street address or PO box for where we can send mail. Fill only if 'Home street address', 'Home suburb/town', 'Home state/territory', 'Home postcode' is different (not same as above). Max length: 54 characters Depends on: Home street address, Home suburb/town, Home state/territory, Home postcode
Postal/contact suburb or town	Text	Enter the suburb, town or locality for the postal/contact address. Fill only if 'Home street address', 'Home suburb/town', 'Home state/territory', 'Home postcode' is different (not same as above). Max length: 54 characters Depends on: Home street address, Home suburb/town, Home state/territory, Home postcode
Postal/contact state or region	Text	Enter the state, territory or region for the postal/contact address (abbreviation or full name). Fill only if 'Home street address', 'Home suburb/town', 'Home state/territory', 'Home postcode' is different (not same as above). Max length: 15 characters Depends on: Home street address, Home suburb/town, Home state/territory, Home postcode
Postal/contact postcode	Text	Enter the postcode or ZIP code for the postal/contact address. Fill only if 'Home street address', 'Home suburb/town', 'Home state/territory', 'Home postcode' is different (not same as above). Max length: 25 characters Depends on: Home street address, Home suburb/town, Home state/territory, Home postcode
Prison status and prison details
Yes	Checkbox	Check this box if you are currently in prison.
No	Checkbox	Check this box if you are not currently in prison.
List prison/detention centre	Checkbox	Check this box if you will provide the name of the prison or detention centre in the adjacent text field.
Prison/detention centre	Text	Enter the name of the prison or detention centre where you are currently held. Fill only if 'Yes' is 'Yes'. Max length: 54 characters Depends on: Yes
Integrated Offender Management System (IOMS) number	Text	Provide your IOMS identification number assigned by the prison authorities. Fill only if 'Yes' is 'Yes'. Max length: 18 characters Depends on: Yes
Proceeds of Crime Order - Belongings Taken?
Belongings taken — No	Checkbox	Check this box if the police have not taken any of your belongings under a proceeds of crime order.
Belongings taken — Yes (Attach a copy of your order)	Checkbox	Check this box if the police have taken any of your belongings under a proceeds of crime order and you will attach a copy of that order.
Protection order application lodged in court (Yes/No)
No	Checkbox	Check this box if no application for a domestic and family violence protection order has been lodged in court.
Yes — Attach a copy of any application(s)	Checkbox	Check this box if an application for a domestic and family violence protection order has been lodged in court, and attach a copy of the application(s).
Q13 Additional details (large text field)
Q13 Additional details	Text	Provide a clear, detailed description of the family or relationship problem including what happened, who was involved, relevant dates and locations, any property or settlement issues, safety or protection order concerns, and any actions you have taken so far. Max length: 14 characters
Q13 Applying for family or relationship problem (No/Yes)
Q13 No	Checkbox	Check this box if you are NOT applying for aid for a family or relationship problem.
Q13 Go to question 17	Checkbox	Check this box when instructed to skip the remaining parts of question 13 and proceed directly to question 17.
Q13 Yes	Checkbox	Check this box if you ARE applying for aid for a family or relationship problem (then indicate which specific problem).
Q13 Other problem types (spousal maintenance/divorce/child protection/violence)
Spousal maintenance	Checkbox	Check this box if your application is about spousal maintenance (seeking financial support from a current or former partner).
Divorce	Checkbox	Check this box if your application concerns divorce or related court processes (dissolution of marriage).
Enforcing a court order or advising an order has been breached	Checkbox	Check this box if you need help enforcing an existing court order or are seeking advice because a court order has been breached.
Child protection (including family group meeting)	Checkbox	Check this box if your application involves child protection issues, including matters dealt with at family group meetings about a child's safety or welfare.
Domestic/family violence	Checkbox	Check this box if your application is about domestic or family violence, including seeking protection orders or other legal help related to abuse.
Q13 Property settlement selection and items
Property settlement	Checkbox	Check this box if your application is about a property settlement so you can indicate which items are part of that settlement. Fill only if 'Q13 Yes' is 'Yes'. Depends on: Q13 Yes
The home you live in	Checkbox	Check this box if the home you currently live in is part of the property settlement. Fill only if 'Property settlement' is 'Yes'. Depends on: Property settlement
A motor vehicle	Checkbox	Check this box if a motor vehicle is included as part of the property settlement. Fill only if 'Property settlement' is 'Yes'. Depends on: Property settlement
Any other real estate (apart from the home you live in)	Checkbox	Check this box if any real estate other than your primary home (for example investment or rental property) is part of the settlement. Fill only if 'Property settlement' is 'Yes'. Depends on: Property settlement
Recreation vehicles (boats/caravans etc)	Checkbox	Check this box if recreation vehicles such as boats or caravans are included in the property settlement. Fill only if 'Property settlement' is 'Yes'. Depends on: Property settlement
Savings	Checkbox	Check this box if bank savings or cash savings are part of the property settlement. Fill only if 'Property settlement' is 'Yes'. Depends on: Property settlement
Shares or bonds	Checkbox	Check this box if shares, bonds or similar investments are included as part of the settlement. Fill only if 'Property settlement' is 'Yes'. Depends on: Property settlement
Superannuation / insurance payments / other sellable valuables	Checkbox	Check this box if superannuation, insurance payments or any other valuable items you could sell are part of the property settlement. Fill only if 'Property settlement' is 'Yes'. Depends on: Property settlement
Other	Checkbox	Check this box if there are other items not listed above that are part of the property settlement. Fill only if 'Property settlement' is 'Yes'. Depends on: Property settlement
Give details (Other)	Checkbox	Check this box (and then provide information in the adjacent box) if you have selected 'Other' and need to give details about those items.
Q13 Other — Give details	Text	Enter a short description of any other property or items included in the settlement (for example item type, brief identifying details or short note about its relevance). Fill only if 'Other' is 'Yes'. Max length: 60 characters Depends on: Other
Q13 Which problem (children/custody/support etc)
Who my children live with (residence/custody)	Checkbox	Check this box if your application is about who your children live with (residence or custody). Fill only if 'Q13 Yes' is 'Yes'. Depends on: Q13 Yes
How much time my children spend with me or the other parent (contact/access)	Checkbox	Check this box if your application is about how much time your children spend with you or the other parent (contact or access arrangements). Fill only if 'Q13 Yes' is 'Yes'. Depends on: Q13 Yes
Decisions about how my children are raised (eg schooling, health, religion)	Checkbox	Check this box if your application is about parental decisions regarding how your children are raised (for example schooling, health or religion). Fill only if 'Q13 Yes' is 'Yes'. Depends on: Q13 Yes
Child support/maintenance/paternity	Checkbox	Check this box if your application is about child support, maintenance or paternity matters. Fill only if 'Q13 Yes' is 'Yes'. Depends on: Q13 Yes
Q14 Current Orders About This Family Matter
Q14 No	Checkbox	Check this box if you do NOT have any current orders about this family matter (for example, no domestic violence protection orders, child protection orders, or similar orders).
Q14 Yes (Attach a copy of any order(s))	Checkbox	Check this box if you DO have any current orders about this family matter (including domestic violence protection orders, child protection orders, etc.) and attach a copy of any orders you have.
Q15 Do They Have a Lawyer?
No	Checkbox	Check this box if the person does not have a lawyer for this legal issue.
Don't know	Checkbox	Check this box if you do not know whether the person has a lawyer.
Yes	Checkbox	Check this box if the person does have a lawyer for this legal issue.
Give details below, if known	Checkbox	Check this box when the person has a lawyer and you will (or can) provide the lawyer's details in the fields below.
Q15 Lawyer Details (If Known)
Lawyer's name	Text	Enter the full name of the lawyer who represents the person involved in this legal matter. Fill only if 'Yes' is 'Yes'. Max length: 53 characters Depends on: Yes
Law firm	Text	Enter the name of the lawyer's law firm or legal practice. Fill only if 'Yes' is 'Yes'. Max length: 53 characters Depends on: Yes
Law firm address	Text	Enter the street address of the law firm, including unit or suite number if applicable. Fill only if 'Yes' is 'Yes'. Max length: 57 characters Depends on: Yes
Suburb/town	Text	Enter the suburb or town where the law firm is located. Fill only if 'Yes' is 'Yes'. Max length: 53 characters Depends on: Yes
State/territory	Text	Enter the state or territory for the law firm's address. Fill only if 'Yes' is 'Yes'. Max length: 15 characters Depends on: Yes
Postcode	Text	Enter the postcode for the law firm's address. Fill only if 'Yes' is 'Yes'. Max length: 26 characters Depends on: Yes
Q15 Person You Have Legal Issue With - Personal Details
Q15 Family name	Text	Enter the family (last) name of the person you have the legal issue with. Max length: 53 characters
Q15 First name	Text	Enter the person's first (given) name. Max length: 53 characters
Q15 Middle name(s)	Text	Enter any middle name(s) of the person, or leave blank if none. Max length: 53 characters
Q15 Street address	Text	Enter the person's street address or residential address (house number and street). Max length: 53 characters
Q15 Suburb / town	Text	Enter the suburb or town where the person lives. Max length: 50 characters
Q15 State	Text	Enter the state or territory where the person resides. Max length: 16 characters
Q15 Postcode	Text	Enter the postal (ZIP) code for the person's address. Max length: 28 characters
Q15 Birth date	Date	Provide the person's date of birth. Max length: 25 characters
Q15 Phone number	Text	Enter the person's primary phone number, including area or country code if available. Max length: 53 characters
Q15 Email	Text	Enter the person's email address if known. Max length: 57 characters
Q15 Relationship to you	Text	Describe the person's relationship to you (for example: spouse, parent, neighbour, employer). Max length: 54 characters
Q17 Apply for Aid for Civil Law Problem (Yes/No)
Q17 Yes — Applying for aid for a civil law problem	Checkbox	Check this box if you are applying for aid for a civil law problem (answer Yes) and will then select which specific problem applies.
Q17 No — Not applying for aid for a civil law problem	Checkbox	Check this box if you are not applying for aid for a civil law problem (answer No) and should proceed to question 18.
Q17 Civil Law Problem Type (Select One)
Q17 - Administrative Appeals Tribunal	Checkbox	Check this box if you are applying for aid for a matter before the Administrative Appeals Tribunal. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Anti-discrimination	Checkbox	Check this box if your civil law problem concerns anti-discrimination issues. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Child protection (Go to question 13 on page 9)	Checkbox	Check this box if your application is about a child protection matter; follow the instruction to go to question 13 on page 9. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Dangerous prisoners	Checkbox	Check this box if your civil law problem relates to dangerous prisoners. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Domestic/family violence (Go to question 13 on page 9)	Checkbox	Check this box if your application is about domestic or family violence; follow the instruction to go to question 13 on page 9. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Inquest	Checkbox	Check this box if you are applying for aid for an inquest matter. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Mental health	Checkbox	Check this box if your civil law problem concerns mental health issues. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Migration	Checkbox	Check this box if your application is about a migration matter. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Peace and good behaviour	Checkbox	Check this box if your civil law problem concerns peace and good behaviour matters. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Veteran’s appeal (war caused) or other defence appeal	Checkbox	Check this box if you are applying for aid for a veteran's appeal (war caused) or another type of defence appeal. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Workers’ compensation	Checkbox	Check this box if your civil law problem relates to workers' compensation. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 - Not sure (Get legal advice)	Checkbox	Check this box if you are not sure what your application is about and need to get legal advice. Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Q17 Follow-up Instruction Acknowledgement
Q17: Please tell us more about your problem under question 18 and sign the declaration on page 14	Checkbox	Check this box to acknowledge you will provide more details under question 18 on page 13 and then sign the declaration on page 14.
Q17 Other Civil Law Problem (Select and Describe)
Q17 Other civil law problem — Other (describe)	Text	Enter a short description of the 'Other' civil law problem you are applying for that is not listed among the options (briefly state what the legal issue is). Fill only if 'Other' is 'Yes'. Max length: 28 characters Depends on: Other
Other	Checkbox	Check this box if your civil law problem is not listed among the options above (select Other and then describe the problem under question 18). Fill only if 'Q17 Yes — Applying for aid for a civil law problem' is 'Yes'. Depends on: Q17 Yes — Applying for aid for a civil law problem
Question 11 - Charged with an offence (Yes/No) and extra details flag
11 - No (Go to question 13)	Checkbox	Check this box if you have not been charged with an offence; selecting it indicates you should skip to question 13.
11 - Yes (List your charges)	Checkbox	Check this box if you have been charged with an offence and you will list the date(s) and details of the charges in the table provided.
11 - List extra details at question 18	Checkbox	Check this box if you need to provide additional details about the charge(s) and will supply those extra details at question 18.
Question 11 Charges - Fifth charge row
Fifth charge — Date charged	Date	Enter the date you were charged for the fifth listed offence. Fill only if '11 - Yes (List your charges)' is 'Yes'. Max length: 12 characters Depends on: 11 - Yes (List your charges)
Fifth charge — Charge description	Text	Enter the wording of the offence or charge for the fifth listed charge (e.g., the offence name or short description). Fill only if '11 - Yes (List your charges)' is 'Yes'. Max length: 72 characters Depends on: 11 - Yes (List your charges)
Question 11 Charges - First charge row
1st charge — Date charged	Date	Enter the date you were charged for the first listed offence. Fill only if '11 - Yes (List your charges)' is 'Yes'. Max length: 11 characters Depends on: 11 - Yes (List your charges)
1st charge — Charge description	Text	Provide the name or short description of the offence you were charged with for the first listed charge. Fill only if '11 - Yes (List your charges)' is 'Yes'. Max length: 66 characters Depends on: 11 - Yes (List your charges)
Question 11 Charges - Fourth charge row
Charge 4 - Date charged	Date	Enter the date you were charged for the fourth listed offence. Fill only if '11 - Yes (List your charges)' is 'Yes'. Max length: 12 characters Depends on: 11 - Yes (List your charges)
Charge 4 - Offence description	Text	Enter the name or brief description of the fourth charge, including the offence title or relevant details that identify the charge. Fill only if '11 - Yes (List your charges)' is 'Yes'. Max length: 72 characters Depends on: 11 - Yes (List your charges)
Question 11 Charges - Second charge row
Charge 2 — Date charged	Date	Enter the date when the second charge was laid or the date of the alleged offence. Fill only if '11 - Yes (List your charges)' is 'Yes'. Max length: 12 characters Depends on: 11 - Yes (List your charges)
Charge 2 — Charge description	Text	Enter the full description or name of the second offence or charge being listed (e.g., the alleged offence or statutory title). Fill only if '11 - Yes (List your charges)' is 'Yes'. Max length: 72 characters Depends on: 11 - Yes (List your charges)
Question 11 Charges - Third charge row
Third charge - Date charged	Date	Enter the date you were charged for the third listed offence. Fill only if '11 - Yes (List your charges)' is 'Yes'. Max length: 12 characters Depends on: 11 - Yes (List your charges)
Third charge - Charge description	Text	Provide the name or brief description of the offence for the third listed charge (e.g., offence type or charge wording). Fill only if '11 - Yes (List your charges)' is 'Yes'. Max length: 72 characters Depends on: 11 - Yes (List your charges)
Question 18 - Legal Problem Details (Narrative)
text__a3f3	Text	Max length: 38 characters
Question 18 — Legal problem detail (Part 1)	Text	Start your narrative by briefly stating what the legal problem is and identifying who is involved. Max length: 92 characters
Question 18 — Legal problem detail (Part 2)	Text	Describe when and how the legal problem started, including approximate dates and the events that led to it. Max length: 67 characters
Question 18 — Legal problem detail (Part 3)	Text	Explain what has happened since the issue began, including key events, communications and developments.
Question 18 — Legal problem detail (Part 4)	Text	List the people or organisations involved and describe their roles or how they are connected to the problem. Max length: 63 characters
Question 18 — Legal problem detail (Part 5)	Text	Provide relevant financial details such as amounts owed, income loss, costs or who is financially responsible.
Question 18 — Legal problem detail (Part 6)	Text	Describe any steps you have already taken to resolve the matter, such as complaints, negotiations, police reports or court action. Max length: 63 characters
Question 18 — Legal problem detail (Part 7)	Text	Give specific dates, locations and other factual details that clarify the timeline and context of the problem.
Question 18 — Legal problem detail (Part 8)	Text	Describe any evidence you have (documents, messages, photos) and whether you can provide copies if requested. Max length: 67 characters
Question 18 — Legal problem detail (Part 9)	Text	List any previous or current legal representation or advice you have received about this matter. Max length: 92 characters
Question 18 — Legal problem detail (Part 10)	Text	Explain how the legal problem is affecting you and any dependants, including impacts on health, housing, employment or finances. Max length: 92 characters
Question 18 — Legal problem detail (Part 11)	Text	Note any urgent or time‑sensitive issues such as upcoming deadlines, court dates or enforcement action. Max length: 48 characters
Question 18 — Legal problem detail (Part 12)	Text	State whether there are any safety concerns, threats or risks to you or others because of this problem. Max length: 92 characters
Question 18 — Legal problem detail (Part 13)	Text	Provide details of any orders, judgments or agreements that relate to this problem, including dates and outcomes. Max length: 67 characters
Question 18 — Legal problem detail (Part 14)	Text	Explain any special circumstances (for example disability, language barriers or homelessness) that affect your ability to deal with the matter.
Question 18 — Legal problem detail (Part 15)	Text	If there are other people who may assist your case, provide their names, contact details and relationship to you.
Question 18 — Legal problem detail (Part 16)	Text	Describe the outcome or resolution you are seeking from this application or any legal action.
Question 18 — Legal problem detail (Part 17)	Text	Add any other relevant information or background about the matter that has not yet been covered. Max length: 67 characters
Question 18 — Legal problem detail (Part 18)	Text	If you have related reference numbers (police, court, tenancy), list them and identify which agency issued each number.
Question 18 — Legal problem detail (Part 19)	Text	Include any important dates such as hearing dates, filing dates or statutory time limits relevant to your case. Max length: 63 characters
Question 18 — Legal problem detail (Part 20)	Text	Explain whether there are other legal proceedings involving the same parties or related issues and give brief details.
Question 18 — Legal problem detail (Part 21)	Text	Provide details of any property, assets or income sources that are relevant to the legal issue. Max length: 63 characters
Question 18 — Legal problem detail (Part 22)	Text	Note any cultural, family or community matters that are relevant to how the problem should be handled.
Question 18 — Legal problem detail (Part 23)	Text	If you have referrals, support workers or advocates assisting you, provide their names, organisations and contact details. Max length: 59 characters
Question 18 — Legal problem detail (Part 24)	Text	Use this final field for any additional notes, clarifications or a short summary that completes your description of the legal problem. Max length: 87 characters
Question 7a - Current living arrangements and income from moved-out property
7a Current living arrangements	Text	Describe your current living arrangements (for example, moved in with a relative, moved to a nursing home, or moved to a lowset house); include any relevant dates or relationships. Fill only if '7a Yes' is 'Yes'. Max length: 69 characters Depends on: 7a Yes
7a Income from moved-out property (weekly)	Number	Enter the amount of any weekly income you receive from the property you moved out of (for example, rent received). Max length: 26 characters
Question 7a - Disability/health move-out question and details
7a No	Checkbox	Check this box if you are 60 years or older and you have NOT had to move out of the home or buy another home because of a disability or health problem.
7a Yes	Checkbox	Check this box if you are 60 years or older and you HAVE had to move out of the home or buy another home because of a disability or health problem.
7a Give details of disability or health problem	Checkbox	Check this box if you are giving details about the disability or health problem that caused you to move out or buy another home (fill in the accompanying text field).
7a – Details of disability or health problem and move-out circumstances	Text	Describe the disability or health problem that caused you (or the person aged 60 or older) to move out or buy another home, and provide details about the move and current living arrangements (for example, reason for moving, dates, who moved in with you, or if you moved to a care facility). Fill only if '7a Yes' is 'Yes'. Max length: 72 characters Depends on: 7a Yes
Question 7a - Home you live in (ownership and equity)
7a - No (the home you live in)	Checkbox	Check this box if neither you nor a person who helps you financially owns or is paying off the home you live in.
7a - Yes (the home you live in)	Checkbox	Check this box if you or a person who helps you financially owns or is paying off the home you live in (if checked, provide the requested value, mortgage and equity details).
7a - Current value of home	Number	Enter the current market value of the home you live in as a monetary amount. Fill only if '7a - Yes (the home you live in)' is 'Yes'. Max length: 30 characters Depends on: 7a - Yes (the home you live in)
7a - Total mortgage on the home	Number	Enter the total outstanding mortgage or loan balance secured against the home. Fill only if '7a - Yes (the home you live in)' is 'Yes'. Max length: 30 characters Depends on: 7a - Yes (the home you live in)
7a - Equity in the home	Number	Enter the amount of equity you (or the person who helps you financially) have in the home (current value minus outstanding mortgage). Fill only if '7a - Yes (the home you live in)' is 'Yes'. Max length: 30 characters Depends on: 7a - Yes (the home you live in)
7a - Date you bought the home	Date	Enter the date when you purchased or completed the purchase of the home. Fill only if '7a - Yes (the home you live in)' is 'Yes'. Max length: 47 characters Depends on: 7a - Yes (the home you live in)
7a - How long you have lived there	Text	Enter how long you have lived in the home, for example '5 years' or '2 years 3 months'. Fill only if '7a - Yes (the home you live in)' is 'Yes'. Max length: 47 characters Depends on: 7a - Yes (the home you live in)
Question 7b - Other real estate (value, mortgage, equity)
7b No	Checkbox	Check this box if you (or the person who helps you financially) do NOT own any other real estate apart from the home you live in.
7b Yes	Checkbox	Check this box if you (or the person who helps you financially) DO own other real estate (for example, a house or land) apart from the home you live in.
7b Give details	Checkbox	Check this box when you will provide details about the other real estate you or the person who helps you financially own (value, mortgage, equity).
7b - Value of other real estate	Number	Enter the current market value of the other real estate you own (for example house or land) before subtracting any mortgage or liabilities. Fill only if '7b Yes' is 'Yes'. Max length: 26 characters Depends on: 7b Yes
7b - Total mortgage on other real estate	Number	Enter the total outstanding mortgage or loan balance secured against this other real estate property. Fill only if '7b Yes' is 'Yes'. Max length: 26 characters Depends on: 7b Yes
7b - Equity in other real estate	Number	Enter the amount of equity you have in this other real estate (market value minus any outstanding mortgage or charges). Fill only if '7b Yes' is 'Yes'. Max length: 28 characters Depends on: 7b Yes
Question 7c - Motor vehicle(s) (equity and details)
7c - Motor vehicle(s)? No	Checkbox	Check this box if neither you nor a person who helps you financially owns or is paying off any motor vehicle(s).
7c - Motor vehicle(s)? Yes	Checkbox	Check this box if you or a person who helps you financially owns or is paying off one or more motor vehicle(s).
7c - Motor vehicle(s)? Give details	Checkbox	Check this box when you need to provide further details about the motor vehicle(s) (for example, equity amount and other requested information) after selecting Yes.
7c. Equity in motor vehicle(s)	Number	Enter the current equity you (or the person who helps you financially) have in all motor vehicle(s), i.e. the vehicle’s value less any outstanding loan amount. Fill only if '7c - Motor vehicle(s)? Yes' is 'Yes'. Max length: 28 characters Depends on: 7c - Motor vehicle(s)? Yes
Question 8 - Money in the bank (bank account details)
Question 8 - No	Checkbox	Check this box if neither you nor a person who helps you financially has any money in the bank.
Question 8 - Yes	Checkbox	Check this box if you or a person who helps you financially has money in the bank.
Question 8 - Give details	Checkbox	Check this box when you (or the person who helps you financially) have money in the bank and you need to provide the bank account amount and attach bank statements or other details.
Question 8 — Bank account balance	Number	Enter the total amount of money held in the bank account for you or the person who helps you financially. Fill only if 'Question 8 - Yes' is 'Yes'. Max length: 20 characters Depends on: Question 8 - Yes
Question 9 - Other valuable assets details
9. Other — Give details	Checkbox	Check this box if you, or a person who helps you financially, have any other valuable assets not listed above and you will provide details in the space provided.
Question 9 — Other assets (give details)	Text	Enter details about any other valuable items you or the person who helps you financially can sell or use now (for example description of the item, ownership, estimated value or any relevant notes). Fill only if 'Question 9 - Other valuable assets value' has a value (non-zero). Max length: 79 characters Depends on: Question 9 - Other valuable assets value
Question 9 - Valuable assets amounts
Question 9 - Shares or bonds value	Number	Enter the current value of any shares or bonds you (or a person who helps you financially) can sell or use now. Max length: 18 characters
Question 9 - Recreation vehicles value	Number	Enter the current value of any recreational vehicles (for example boats or caravans) you (or a person who helps you financially) can sell or use now. Max length: 20 characters
Question 9 - Accessible superannuation / insurance / other items value	Number	Enter the amount you can access from superannuation, insurance payments, or other valuable items you (or a person who helps you financially) can sell or use now. Max length: 18 characters
Question 9 - Other valuable assets value	Number	Enter the value of any other valuable assets you (or a person who helps you financially) can sell or use now and provide details in the space provided. Max length: 18 characters
Relationship type with other person
A family relationship with the other person (relative or extended family)	Checkbox	Check this box if your relationship with the other person is a family relationship, such as a relative or member of your extended family. Fill only if 'Domestic/family violence' is 'Yes'. Depends on: Domestic/family violence
A spousal relationship with the other person (including defacto relationships)	Checkbox	Check this box if you are or were in a spousal relationship with the other person, including married or de facto relationships. Fill only if 'Domestic/family violence' is 'Yes'. Depends on: Domestic/family violence
An informal care relationship with the other person	Checkbox	Check this box if your relationship with the other person is an informal care relationship where you provide ongoing care or support to them. Fill only if 'Domestic/family violence' is 'Yes'. Depends on: Domestic/family violence
An intimate personal relationship with the other person	Checkbox	Check this box if your relationship with the other person is an intimate personal relationship (for example, a romantic or sexual partner). Fill only if 'Domestic/family violence' is 'Yes'. Depends on: Domestic/family violence
Not applicable	Checkbox	Check this box if none of the listed relationship types describe your situation with the other person. Fill only if 'Domestic/family violence' is 'Yes'. Depends on: Domestic/family violence
Second Person Charged - Has a Lawyer?
Second person charged — Has a lawyer? No	Checkbox	Check this box if the second person charged does not have a lawyer.
Second person charged — Has a lawyer? Yes	Checkbox	Check this box if the second person charged does have a lawyer (provide the lawyer's details below, if known).
Second person charged — Has a lawyer? Don't know	Checkbox	Check this box if you do not know whether the second person charged has a lawyer.
Second Person Charged - Lawyer Details
Second person's lawyer - Name	Text	Enter the lawyer's full name who represents the second person charged. Fill only if 'Second person charged — Has a lawyer? Yes' is 'Yes'. Max length: 57 characters Depends on: Second person charged — Has a lawyer? Yes
Second person's lawyer - Law firm	Text	Enter the name of the law firm or legal practice representing the second person charged. Fill only if 'Second person charged — Has a lawyer? Yes' is 'Yes'. Max length: 53 characters Depends on: Second person charged — Has a lawyer? Yes
Second person's lawyer - Address	Text	Enter the street address for the lawyer or law firm (including building number and street name). Fill only if 'Second person charged — Has a lawyer? Yes' is 'Yes'. Max length: 57 characters Depends on: Second person charged — Has a lawyer? Yes
Second person's lawyer - Suburb/town	Text	Enter the suburb or town for the lawyer's address. Fill only if 'Second person charged — Has a lawyer? Yes' is 'Yes'. Max length: 57 characters Depends on: Second person charged — Has a lawyer? Yes
Second person's lawyer - Postcode	Text	Enter the postcode for the lawyer's address. Fill only if 'Second person charged — Has a lawyer? Yes' is 'Yes'. Max length: 27 characters Depends on: Second person charged — Has a lawyer? Yes
Second person's lawyer - State	Text	Enter the state for the lawyer's address (for example, the two-letter or full state name). Fill only if 'Second person charged — Has a lawyer? Yes' is 'Yes'. Max length: 16 characters Depends on: Second person charged — Has a lawyer? Yes
Second Person Charged - Personal Details
Second person – Family name	Text	Enter the second person charged’s family (last) name as it appears on official documents. Max length: 53 characters
Second person – First name	Text	Enter the second person charged’s given (first) name. Max length: 57 characters
Second person – Middle name(s)	Text	Enter any middle name(s) of the second person charged, or leave blank if none. Max length: 53 characters
Second person – Street address	Text	Enter the second person charged’s full street address, including unit or apartment number if applicable. Max length: 53 characters
Second person – Suburb/town	Text	Enter the suburb or town where the second person charged lives. Max length: 57 characters
Second person – State	Text	Enter the state or territory of the second person charged’s residential address. Max length: 16 characters
Second person – Postcode	Text	Enter the postcode for the second person charged’s address. Max length: 27 characters
Second person – Birth date	Date	Provide the second person charged’s date of birth. Max length: 27 characters
Self-employment status for you or financial helper (Q4)
No	Checkbox	Check this box if neither you nor anyone who financially helps you is self-employed, a small business owner, or a farmer.
Yes	Checkbox	Check this box if you or someone who financially helps you is self-employed, a small business owner, or a farmer.
Give details / Attach details of self employment	Checkbox	Check this box when you (or the person who helps you) are self-employed and you will provide or attach the requested details of the self‑employment.
Q4 Self‑employment details (1)	Text	Enter the self‑employment details for you or the person who helps you financially, including the business name, nature of the work or services provided, contact/ABN or identifier, trading address and the period/dates of operation. Fill only if 'Yes' is 'Yes'. Depends on: Yes
Special Circumstances (No/Yes)
Special Circumstances — No	Checkbox	Check this box if you do not have any special circumstances (for example long‑standing illness, inability to read or write, inability to access assets or money, or inability to work).
Special Circumstances — Yes	Checkbox	Check this box if you have one or more special circumstances (for example long‑standing illness, inability to read or write, inability to access assets or money, or inability to work); if checked, list details at question 18 as requested.
Submission Instructions Acknowledgement
Post or hand-deliver completed form	Checkbox	Check this box when you will submit your completed application by posting it to GPO Box 2449 Brisbane Q 4001 or by hand-delivering it to your nearest Legal Aid office.
Title (Mr/Mrs/Ms/Miss/Other) and Other Title Details
Other title — give details	Text	Enter the text of your other title (for example Dr, Prof, Reverend) to specify the title when 'Other' is selected; leave blank if not applicable. Fill only if 'Other (Give details)' is 'Other'. Max length: 11 characters Depends on: Other (Give details)
Mr	Checkbox	Check this box if your title is Mr.
Mrs	Checkbox	Check this box if your title is Mrs.
Ms	Checkbox	Check this box if your title is Ms.
Miss	Checkbox	Check this box if your title is Miss.
Other (Give details)	Checkbox	Check this box if you use a title not listed above, and enter that title in the adjacent 'Give details' field.
Top Page Banner Field
Top page banner text	Text	Enter the text that should appear in the top page banner (for example a heading, reference number or short label) exactly as it should be displayed. Max length: 43 characters
Total weekly gross household income
Total weekly gross household income (before tax)	Number	Enter the household’s total gross income per week before tax from all sources (wages, salaries, benefits, pensions, child support, maintenance, rental income, etc.). Max length: 10 characters
Was anyone else charged with you? (Yes/No/Not sure)
Yes	Checkbox	Check this box if at least one other person was charged with you and you will provide their details below.
No — Go to question 12	Checkbox	Check this box if no one else was charged with you; if checked, skip to question 12.
Give details	Checkbox	Check this box to indicate you can give details about the other person(s) charged and then fill in the fields provided.
Not sure	Checkbox	Check this box if you do not know whether anyone else was charged with you.
Which court or tribunal (type selection + tribunal details)
Magistrates Court	Checkbox	Check this box if the matter you must attend is in the Magistrates Court. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
District Court	Checkbox	Check this box if the matter you must attend is in the District Court. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Tribunal details	Text	Enter the name and specific details of the tribunal you must attend (for example the tribunal name, branch or location and any reference/case number). Fill only if 'Tribunal (Give details)' is 'Yes'. Max length: 47 characters Depends on: Tribunal (Give details)
Tribunal (Give details)	Checkbox	Check this box if the matter is before a tribunal and provide the tribunal name/details in the adjacent field. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Court of Appeal	Checkbox	Check this box if the matter you must attend is in the Court of Appeal. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Childrens Court	Checkbox	Check this box if the matter you must attend is in the Childrens Court. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Family Court of Australia	Checkbox	Check this box if the matter you must attend is in the Family Court of Australia. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Federal Circuit Court	Checkbox	Check this box if the matter you must attend is in the Federal Circuit Court. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Supreme Court	Checkbox	Check this box if the matter you must attend is in the Supreme Court. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Mental Health Court	Checkbox	Check this box if the matter you must attend is in the Mental Health Court. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Drug Court	Checkbox	Check this box if the matter you must attend is in the Drug Court. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Not sure	Checkbox	Check this box if you do not know which court or tribunal you must attend. Fill only if 'Do you have to go to court or a tribunal? — Yes' is 'Yes'. Depends on: Do you have to go to court or a tribunal? — Yes
Your health care/pension card details
Your card number	Text	Enter the full number from your current health care or pension card as shown on the card. Max length: 60 characters
Your card expiry date	Date	Enter the expiry date shown on your health care or pension card. Max length: 14 characters
Your card type - Health care	Checkbox	Check this box if the card you are providing for yourself is a Health Care card.
Your card type - Pension	Checkbox	Check this box if the card you are providing for yourself is a Pension card.
Your legal problem (sections/divisions)
Section 1 — General/other legal problem	Text	Enter a short title or identifier for the first (general or other) legal-problem section that applies to your matter. Max length: 65 characters
Section 2 — Criminal law problem	Text	Provide a brief title or identifier for the criminal law problem (Section 2) relevant to your case, for example 'assault' or 'drug offence'. Max length: 57 characters
Section 3 — Family or relationship problem	Text	Provide a short description or identifier of the family or relationship problem (Section 3) relevant to your matter, for example 'divorce' or 'child custody'. Max length: 57 characters
Section 4 — Civil law problem	Text	Enter a brief title or identifier for the civil law problem (Section 4) that applies to your case, for example 'tenancy dispute' or 'contract dispute'. Max length: 60 characters

Legal Aid Queensland application form (LAQAPP) Instructions