New York > Statewide > Family Court > Child Protective
Petition For Extension Of Supervision 10-27 - New York
| Petition For Extension Of Supervision Form. This is a New York form and can be used in Child Protective Family Court Statewide . |
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F.C.A §§1054, 1057 Form 10-27 (Child Protective Petition for Extension of Supervision ) (9/2006) FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF ............................................................................... In the Matter of CIN # A Child Under Eighteen Years of Age to be GNeglected GAbused by Docket No. PETITION FOR EXTENSION OF SUPERVISION1 Respondents .............................................................................. TO THE FAMILY COURT: The undersigned Petitioner respectfully alleges upon information and belief that: 1. a. Petitioner, , is the Commissioner of Social Services of [specify]: County an agency duly authorized for the placement of children under Article 10 of the Family Court Act. b. Petitioner's principal office is located at [specify]: , New York. 2. a. By order of this Court, dated [specify]: , the above-named child, who was born on [specify date]: , was found to be G neglected G abused G severely abused G repeatedly abused by [specify Respondent(s)]: b. An Order of Disposition, dated [specify]: , placed Respondent [specify]: under the supervision of [specify agency]: until [specify expiration date]: , pursuant to Family Court Act §1057. released the child to the following parent or other person legally responsible [specify]: under the supervision of [specify agency]: until [specify expiration date]: , pursuant to Family Court Act §1054. c. [Delete if inapplicable]: By order of this Court, dated [specify]: this order of supervision was extended for a period of __ months, terminating on [specify]: , This form should be used only for an extension of an order of supervision that had not been issued together with an order of placement. If the child was placed, the order of supervision extends until the completion of the permanency hearing on the placement and may be continued along with the placement. American LegalNet, Inc. www.FormsWorkflow.com 1 Form 10-27 Page 2 d. The child currently resides with [specify]: 3. Good cause exists for this Court to extend the period of supervision for a period of __ months, terminating on [specify date]: for the following reason(s) [specify]: 4. No previous application has been made to any court or judge for this relief (except [specify; delete if inapplicable]: ). WHEREFORE, Petitioner requests that this Court conduct a hearing, make a finding of good cause to extend the period of supervision, enter an order extending the period of supervision for a period of ____ months, pursuant to Section [check applicable box]: G 1054 G 1057 of the Family Court Act, and grant such other and further relief as the Court deems appropriate, including, but not limited to, the following [specify]: Dated: , . ______________________________________ Petitioner ______________________________________ Print or Type Name ______________________________________ Attorney, if any ______________________________________ Attorney's Name (print or type) ______________________________________ ______________________________________ ______________________________________ Attorney's Address and Telephone Number VERIFICATION STATE OF NEW YORK COUNTY OF ) )ss.: ) being duly sworn, deposes and says: That (s)he is and is acquainted with the facts and circumstances of the above-entitled proceeding; that (s)he has read the foregoing petition and knows the contents thereof; that the same is true to (his(her) own knowledge except as to those matters therein stated to be alleged upon information and belief, and that as to those matters (s)he believes it to be true. Petitioner Sworn to before me this day of ______________________ (Deputy)(Clerk of the Court) (Notary Public) American LegalNet, Inc. www.FormsWorkflow.com
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