eLaws | eCases | State of New York |
 New York Codes Rules Regulations (Last Updated: March 27,2024)
 TITLE 22. Judiciary
 Subtitle D. Forms
 Chapter IV. Forms of the Family Court of the State of New York and Adoption Forms of the Family Court of the State of New York (cf. s205.7)
 Subchapter A. Forms Authorized by Section 205.7
  Person in Need of Supervision (Family Court Act Article 7)
  7-11 Discontinuance of treatment

  7-11 Discontinuance of treatment  

Secs. 756, 771, 772 F.C.A.
 
Form 7-11
 
(Person in Need of Supervision)
 
7/83
___________
In the Matter of
 
Docket No.
__
_______
 
PETITION
A Person Alleged to Be a Person In
Need of Supervision,
 
(Discontinuance of
 
Treatment) _______ Respondent. ___________
TO THE FAMILY COURT:
The undersigned Petitioner respectfully alleges that:
1. Petitioner, __, is an authorized agency with which the above-named respondent has been placed by Order of this Court dated __, 19 , pursuant to section 756 of the Family Court Act.
2. Petitioner (has discontinued or suspended its work in that: [state facts]
 
 
) (is unwilling to care for the above-named respondent for the reason that support by (the State of New York) (__, one of its political subdivisions) has been discontinued in that: [state facts]
 
 
) (has fundamentally altered its program and as a result the above-named respondent can no longer benefit from it, in that: [state facts]
 
 
).
3. No previous application has been made to any court or judge for the relief herein requested (except
 
 
).
WHEREFORE, petitioner prays that an Order be made and entered returning respondent to this Court for such further or other disposition as to the Court may seem just and proper.
Petitioner
By:______________
(Title)
VERIFICATION (Agency)
STATE OF NEW YORK
 
)
 
) ss.:
COUNTY OF
 
)
__, being duly sworn, deposes and says:
That (s)he is the __ of __, an agency authorized to originate the above-entitled proceeding, and is acquainted with the facts and circumstances therein; that (s)he has read the foregoing and knows the contents thereof; that the same is true to (his) (her) own knowledge, except as to matters therein stated to be alleged on information and belief and as to those matters (s)he believes it to be true.
Name
Title
Sworn to before me this __ day of __, 19.
Notary Public