Recognizance To Produce Child {7-1}

F.C.A. §§724,735 Form 7-1 (Recognizance to Produce Child ­ Person in Need of Supervision) (4/2005) FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF ________________ RECOGNIZANCE TO PRODUCE CHILD I, [specify name]: _____________________________, residing at [specify address]: ___________________________________________, am the [check applicable box]: Qparent Qother person legally responsible for the care of [specify child's name]:____________ ________________, a child born on [specify date of birth]: _____________________________. I hereby promise to bring the child on [specify date and time]: ______________________ to the following agency designated to provide diversion services [check applicable box]: Q Department of Probation, located at [specify address]: __________________________ __________________________________________________________________ Q Department of Social Services, located at [specify address]: _____________________ __________________________________________________________________ Q New York City Administration for Children's Services, located at [specify address]: __________________________________________________________________ I UNDERSTAND THAT IF I DO NOT BRING THE CHILD AS PROMISED TO THE ABOVE-NAMED AGENCY ON THE DATE AND TIME INDICATED, THE FAMILY COURT MAY ISSUE A WARRANT DIRECTING THAT I AND MY CHILD BE BROUGHT TO THE FAMILY COURT. Dated: ______________ _________________________________________ Signature of Parent or Person Legally Responsible _________________________________________ PRINT NAME American LegalNet, Inc. www.USCourtForms.com