General Form 40 - Petition For Modification Of An Order Of Custody/visitation Page 8
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9Page 1 of 2
NCFC 5/2016
Complete these pages only if you have checked
yes to all three of the questions in section 8 of the
petition.
FILE #
DOCKET # (s)
8a.
Child Protective Attachment (To be used for a
Petition for Modification of Order of Custody
(Court use only)
Made by NYS Family Court or NYS Supreme
Court only)
These pages are applicable to cases in which a child protective (neglect or abuse) petition, destitute
child petition, or a permanency hearing report has been filed regarding the child(ren), the petition or
report is currently open, and you are not a parent of the child(ren).
1.
Check
one box.
G
A child protective petition was filed in:
[specify name of court]:
on [specify date petition was
filed]:
, Docket #:
, alleging that
[specify name of respondent(s) on that petition]:
,
neglected or abused the child(ren) who is(are) the
subject(s) of this custody petition.
G
A destitute child petition was filed in [specify name of court]:
on [specify date petition was filed]:
, Docket #:
,
alleging that the child(ren) who is(are) the subject(s) of this custody petition is(are) (a)
destitute child(ren).
2.
Check
, if applicable:
G
The petition above resulted in a finding being made.
Check
one box:
G
The disposition was as follows:
G
The disposition has been adjourned pending a consolidated hearing with this
petition, pursuant to F.C.A. § 1055-b for a neglect or abuse petition or F.C.A. §
1095 for a destitute child petiton. The next court date is:
.
3.
Check
, if applicable:
G
A permanency report pursuant to Article 10-A of the F.C.A. was filed in the Family Court
indicating a permanency plan of custody of the child(ren) with the petitioner.
Name of the County:
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