FORM 35A.3
Form of vulnerable witness application
Rule 35A.3
VULNERABLE WITNESSES (SCOTLAND) ACT 2004 Section 12

Received the …………day of …………20…………
(Date of receipt of this notice)
……………..(signed)
Depute Clerk of Session
In the Cause (Cause Reference No.    )
[A.B.] (designation and address)
Pursuer [or Petitioner]
against
[C.D.] (designation and address)
Defender [or Respondent]

VULNERABLE WITNESS APPLICATION
1.  The applicant is the pursuer [or petitioner] [or defender] [or respondent] in the action by [A.B] (design) against [C.D.] (design). 
2.  The applicant has cited [or intends to cite] [E.F.] (date of birth) as a witness.
3.  The applicant considers that [E.F.] is a vulnerable witness under section 11(1)(b) of the Vulnerable Witnesses (Scotland) Act 2004 for the following reasons:–
(here specify reasons witness is considered to be a vulnerable witness). 
4.  The applicant considers that the following special measure[s] is [are] the most appropriate for the purpose of taking the evidence of [E.F.]:–
(specify any special measure(s) sought).
5.  The reason[s] this [these] special measure[s] is [are] considered the most appropriate is [are] as follows:–
(here specify the reason(s) for the special measures(s) sought).
6.  [E.F.] has expressed the following view[s] on the special measure[s] that is [are] considered most appropriate:–
(set out the views expressed and how they were obtained).
7.  Other information considered relevant to this application is as follows:–
(here set out any other information relevant to the vulnerable witness application).

8.  The applicant asks the court to–

(a)	consider this vulnerable witness application;
(b)	make an order authorising the special measure[s] sought.

…………………………….………(Signed)

Solicitor [or Agent] for A.B. [or C.D.] (include full designation)

NOTE:  This form should be suitably adapted where section 16 of the Act of 2004 applies.