21-B Order (temporary guardianship of the person)  

D.R.L. § 115-c

Form 21-B

S.C.P.A. § 1725

(Temporary

Guardianship)

12/97

At a term of the Surrogate's Court of the

State of New York, held in and for the

County of

,

at

New York

on

, 19 .

PRESENT:

Hon. Judge

In the Matter of the Temporary

(Docket) (File) No.

Guardianship of A Child Whose

First Name is

ORDER

(Temporary

Guardianship

of the Person)

Upon reading and filing the petition herein duly verified on

 

applying for (temporary guardianship of

 

, a child placed for adoption,) (an order approving the adoption of

, an adoptive child) and it appearing that the child will be residing with the Petitioner(s) and that Petitioner(s) intend to file for adoption of the child within 45 days of the execution of the consent to the adoption of the child, and the Court having inquired of the statewide central register of child abuse and maltreatment and having been informed that the (child) (Petitioner(s)) (is)(are)(not) a subject of or another person named in an indicated report filed with such register as such terms are defined in section 412 of the Social Services Law, and the Court having given due consideration to any information contained therein,

ORDERED that

be appointed temporary guardian(s) of the person

of

: and it is further

ORDERED that this order shall expire on

or the date a final order of adoption is entered, whichever is sooner.)

(ORDERED that upon notice to

, the Petitioner(s)

shall appear on the

 

day of

 

, 19 , at

to show cause why the child should not be removed from their home;)

(Surrogate)

Dated:

, 19 .