Application For Return Of Child Temporarily Removed From Home {10-4}

F.C.A. §1028 Form 10-4 (Child Protective ­ Application for Return of Child Temporarily Removed from Home) (9/2006) FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF -----------------------------------------------------------------In the Matter of Docket No. CIN # (A) Child(ren) under the Age of Eighteen years Alleged to be Abused Neglected by Respondent(s) -----------------------------------------------------------------TO THE FAMILY COURT: Application for Return of Child Temporarily Removed From Home 1. I am the Respondent Law Guardian in the above-entitled proceeding. 2. The following child(ren)[specify]: (was)(were) temporarily removed from the place where the child(ren) resided on [specify date]: The child(ren) were removed [check box]: by order of the Family Court, dated [specify]: upon the Respondent's written consent; on an emergency basis without a court order. 3. A petition has has not been filed under Section 1031 of the Family Court Act. 4. No previous application has been made to any court or judge for the relief requested herein, (except)[specify]: WHEREFORE, I respectfully request a hearing regarding the return of the child(ren). Dated: Respondent ____________________________________ Respondent's Address, Telephone No. _____________________________________ Attorney for Respondent _____________________________________ Attorney's Address, Telephone No. Law Guardian _____________________________________ Law Guardian's Address, Telephone No. American LegalNet, Inc. www.FormsWorkflow.com