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Petition Modification Of Order Of Commitment 3-24 - New York
| Petition Modification Of Order Of Commitment Form. This is a New York form and can be used in Juvenile Delinquency Family Court Statewide . |
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Sec. 322.1 F.C.A. Form 3-24 (Juvenile Delinquency) 7/83 FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF In the Matter of A Person Alleged to be a Juvenile Delinquent, Docket No. PETITION (Modification of Order of Commitment) Respondent. -- - - - - - - - - - - - TO THE FAMILY COURT: The undersigned (appearing on behalf of the) Petitioner respectfully alleges that: *(1. Petitioner is the (Commissioner of Mental Health) (Commissioner of Mental Retardation and Developmental Disabilities) and pursuant to an order of this Court, dated -, 20, petitioning Respondent in the above-entitled proceeding has been committed to a residential facility within the appropriate office of the Mental Hygiene Department.) *(1. (S)he is the of the petitioning Respondent in the above-entitled proceeding and is appearing on behalf of said child for the purpose of filing this petition.Pursuant to an order of this Court dated , 20 , petitioning Respondent has been committed to a residential facility within the appropriate office of the Mental Health Department.) 2. Petitioner believes that the continued commitment of the above-named child in such residential facility is no longer appropriate in that *Select applicable 2002 © American LegalNet, Inc. Form 3-24 page 2 WHEREFORE, Petitioner requests a hearing for a modification of the order of commitment 'dated , 20 , to authorize the transfer of Respondent to a non-residential facility. Dated: , 20 Commissioner) By Name Title ) (By On Behalf of the Petitioner (Child) i ) 2002 © American LegalNet, Inc. Form 3-24 page 3 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 trrue 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 , 20 (Notary Public) 2002 © American LegalNet, Inc. Form 3-24 page 4 VERIFICATION (Individual) STATE OF NEW YORK ) ss.: COMITY 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 thereof; 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 there=n stated to be alleged on information and belief and as to those matters (s)he believes it to be true. to before me this day of , 20 (Deputy) (Clerk of the Court) (Notary Public) 2002 © American LegalNet, Inc.
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