COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.17-A Guardianship Proceeding Checklist of Mentally Retarded/Developmentally Disabled Person (Person and/or Property)Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)(see Surrogate's Court Form GMD-1, rev. 4/98)Fill in All Areas On All Pages -Also Mark When Not Applicable When Necessary Check All Forms To Make Sure Venue Is Correct -Appropriate County Is ListedPET. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .¶ #DESCRIPTIONYESNODoesthe Courthave jurisdiction over the subject MR/DDP, hereinafter referred toas respondent [see SCPA §1702]? NOTE:The respondent must bedomiciledinthecounty,havesojournedinthe countyimmediatelypreceding the application for guardianship, or if a non-domiciliary of the state, must have property situate in the county. The domicileof the respondent'sparent(s) or spouse if respondent is married, or custodial parent in the case of an infant respondent is the domicile of the respondent. Is the captioned name the same as the birth certificate and ¶2 of petition? 22NYCRR 207.15(a) and SCPA §1752(1)THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County of1.Is the petitioner a proper party? [see SCPA §1751] Is the petitioner ...o'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomboth parents or the survivor, or one parent any person eighteen (18) years of age or older, including aYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.corporation authorized to serve as a guardian, interested in the welfare of the respondent the respondent when such person is eighteen (18) years ofage or older, one of the Justices of theCourt in Witness, Honorableday of, 20 County,Are all A/K/A's listed?2.Is the name and date of birth of the respondent in ¶2 the same as that listed on the Birth Certificate? [SCPA §1752(1)](Attorney must sign above and type name below)Attorney(s) forCopy of Birth Certificate from official registrar (not hospital) to be filed with petition [see NYCRR §207.15(a)] Confirm that all required addresses are set forth. 3.Check that names and post office addresses of the parents, children, adult siblings (18 years of age or older) or spouse and primary care physician of the respondent are listed. [see SCPA §1752(3)]Office and P.O. AddressIf any relatives are deceased their names must still be shown and death noted. (Court may require copy of death certificate)Telephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comG17A-CHK release 7/14/03 PAGE 1COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.PETCalendar No.¶ #DESCRIPTIONYESNOJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)3. cont.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOIf the name of the father is not shown on petition or birth certificate, determine if a proceeding has been brought to establish paternity. (Court may require copy of filiation order) [see page 5 -Comments & Court Notes] NOTE: If it is claimed that the identity of the father is unknown, the Court may require an affidavit showing diligent efforts to identify him. NOTE: If the natural mother was married at the time of respondent's birth, there is a rebuttable presumption that her husband is the father of the respondent and is a necessary party unless a filiation order has established otherwise. [see DRL §24(1)] 4.List names/addresses of adults with whom respondent resides if other than parent or facility at which respondent resides. [see SCPA §1752(4)] 5.Check that names and addresses, education and other qualifications of proposed guardian, standby or alternate guardian, if other than respondent's parents, spouse, adult children or adult siblings is properly listed. [see SCPA §1752(5)] Check that any necessary waivers/renunciations/consents are filed by any parent not a petitioner. (Form GMD-3)GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forNOTE: SCPA §1753(1) requires that process shall issue to: 1. Parent or Parents (if other than petitioner) 2. Adult children, adult siblings (if other than parents) 3. Spouse (if respondent is married); 4. Person having care and custody or with whom respondent resides (if other than parent or spouse);5. The respondent (if fourteen (14) years of age or older). NOTE: SCPA §1753(2) requires that a Notice of Petition be served by certified mail to: 1. Adult siblings 2. Mental Hygiene Legal Services 3. Director of any State Facility where respondent resides 4. Adult children 5. Any other person Court deems proper 6. Any person designated in writing by respondent NOTE: No process or notice is necessary to any person above who has been declared by the court as incompetent or who has, as appears to the Court's satisfaction, abandoned the respondent or to a spouse who is divorced from the respondent. [see SCPA §1754(2)] 6.Check that names and addresses of the proposed guardians, standby guardians or alternate guardians are listed and confirm that the boxes checked reflect the relief requested.Check that proper consents/oaths/designations or consents/designations are complete
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