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New York Codes Rules Regulations (Last Updated: March 27,2024) |
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TITLE 22. Judiciary |
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Subtitle D. Forms |
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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) |
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Subchapter A. Forms Authorized by Section 205.7 |
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Person in Need of Supervision (Family Court Act Article 7) |
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7-9 Petition (termination of placement) |
TO THE FAMILY COURT: The undersigned Petitioner respectfully alleges upon information and belief that: 1. Petitioner, ___________, is the □ parent □ guardian □ next friend of the above-named Respondent, and resides at [specify]: OR Petitioner, ___________, is a duly authorized agency that has its principal office at [specify]: 2. Under an Order of Fact-finding and Disposition of this Court, dated ____, the Respondent was adjudicated to be a person in need of supervision within the meaning of Article 7 of the Family Court Act and placed in the custody of _____ for a period of __ months, terminating on __. 3. Respondent is now in the custody of [specify]: __ and the placement should be terminated for the following reasons: 4. No previous application has been made to any court or judge for this relief (except [specify]: _______.) 5. The Petitioner has made application to the agency with which the child has been placed for the release of Respondent, which application was [check applicable box]: □ denied □ not granted within thirty days from the day application was made). WHEREFORE, Petitioner requests this Court to issue an Order terminating the placement of Respondent and directing release. Dated: ______. Petitioner By: Name Title Signature of Attorney, if any Attorney's Address and Telephone Number Form 7-9 Page 2 VERIFICATION (Individual) STATE OF NEW YORK ) ) ss.: COUNTY OF ) ___________, being duly sworn, deposes and says: That (s)he is the ___________ in 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. ______________ Sworn to before me this __ day of ___, . (Deputy) (Clerk of the Court) (Notary Public) 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 ___ Notary Public |
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