......................Applicant

of ..........................

.....................Respondent(s)

of .........................

WHEREAS ON APPLICATION by ............................ of .......................................

made under section 47 of the above-mentioned Act, THE COURT on the ...... day of ............. 19....., MADE AN ORDER on question affecting the welfare of the above-named child, who is in the care of the ................... Health Board in the said Court district, to the following effect—

NOW, THE COURT on the application of the applicant herein for an order under the said section 47 to *vary *discharge *(that order) *(the following direction contained in that order—

being satisfied that notice of the application was duly served,

having heard the evidence tendered, and

being satisfied that the welfare of the child so requires,

HEREBY ORDERS that the said *order *direction

*BE DISCHARGED

*BE VARIED as follows:—

Dated this.............. day of.................. 19.............

Signed ..................

Judge of the Children Court

*(assigned to the said district)

* Delete words inapplicable