You can use the FL401 form to apply for:
- a non-molestation order, which protects you and any relevant child from abuse or harassment – this order can also prevent someone coming to or near your home
- an occupation order, where the court decides who should live in, or return to, the home or any part of it
These orders are types of injunction.
There are no court fees for applying. You can apply for either order or both, depending on your situation.
The form includes further information and guidance to help you complete your application.
You must also complete a supporting witness statement. Our template is designed to help you provide all the information needed by the court. You do not need to use this template if you would prefer to write your own statement. However, you may still find the guidance in our template helpful.
If you choose to write your own supporting statement, it must include the following ‘statement of truth’, along with your signature and the date:
I understand that proceedings for contempt of court may be brought against anyone who makes, or causes to be made, a false statement in a document verified by a statement of truth without an honest belief in its truth. I believe that the facts stated in this form and any continuation sheets are true.
Support with applying for an order
CourtNav is an online tool (provided by RCJ Citizens Advice) that will help you in putting together your application. The tool will also put you in touch with legal advisors to discuss your options.
Visit CourtNav to register and apply.
If you choose to use CourtNav, you will not need to complete this FL401 form or a supporting statement – CourtNav will complete both for you.
Open a document
You can download and open PDF documents on your device. Downloading enables more features to be used, such as printing.
Adobe Reader is a free to use PDF viewer. You can use this to view, fill in and print PDF documents. You do not need to sign up for a free trial.
Follow these steps:
Download Adobe Reader for free.
- Right-click on the document link then select ‘Save link as’ or ‘Download linked file’.
- Save the form (in your ‘documents’ folder, for example).
- Open Adobe Reader and then select the saved form.
If the form still does not open, contact email@example.com.
If you need a printed version contact your local court.
Request accessible formats
You can request:
- a Braille version
- a large print version
- an easy read version
Request an accessible format by emailing firstname.lastname@example.org
Microsoft Word is not generally suitable for our documents. You can only request a conversion of a PDF form to Word format as a reasonable adjustment under the Equality Act 2010. Find out more about the Equality Act 2010 in the guidance.