Petition For Withdrawal Of An Infant'S Funds - New York Supreme Court

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[Fill in he spaces next to the instructions. Other spaces are for Court use.]
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
Present:
Hon.
Justice of the Supreme Court
----------------------------------------------------------------------------x
[1. Index No. & Year]
,
Index No.
[2. Fill in name(s)]
Plaintiff(s)
/
PETITION FOR
-against-
WITHDRAWAL OF AN
INFANT’S FUNDS
,
[3. Fill in name(s)]
Defendant(s)
-----------------------------------------------------------------------------x
TO THE SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF NASSAU:
The petition of [4. Your name]
guardian
of infant [5. Insert infant name]
respectfully shows to
this court:
1. Infant is [6. Insert infant age]
and infant date of birth is
[7. Insert infant date of birth.]
2. Infant resides at [8. Insert Infant Residence]
3. The original bank deposit was [9. Insert Amount]$
and was made on
[10. Insert Date of Deposit]
.
4. The petitioner received [11. Insert Amount, if none write zero] $
,
in settlement of the action for loss of services.

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