Petition - Family Court Of The State Of New York printable pdf download

Petition - Family Court Of The State Of New York

F.C.A. §§ 712, 732, 733, 736

Form 7-4

(Person in Need of

Supervision–Petition)

9/2012

FAMILY COURT OF THE STATE OF NEW YORK

COUNTY OF

..........................................................................................

In the Matter of

Docket No.

A Person Alleged to be a Person

In Need of Supervision,

PETITION

Respondent

..........................................................................................

TO THE FAMILY COURT:

The undersigned Petitioner respectfully alleges upon information and belief that:

1. Petitioner,

, resides at

2. Petitioner is a person authorized to institute a proceeding under Article 7 of the Family

Court Act by reason of the fact that (s)he is [specify relationship to Respondent]:

3. The Respondent above-named is a [check applicable box]: Gmale Gfemale who was

born on [specify]:

4. The Respondent [check applicable box]: G is G is not a Native American child subject to

the Indian Child Welfare Act of 1978 (25 U.S.C. §§ 1901-1963). If so, the following have been notified

[check applicable box(es)]:

parent/custodian [specify name and give notification date]:

tribe/nation [specify name and give notification date]:

United States Secretary of the Interior [where tribe/nation undetermined; give notification date]:

5. a. The following are the names and addresses, unless ordered confidential pursuant to

Family Court Act §154-b, of the parent(s) or other person(s) legally responsible for the care of

Respondent or with whom Respondent resides:

Name

Residence

Relationship

b. The following are the names and addresses, unless ordered confidential pursuant to Family

Court Act §154-b, of Respondent’s non-custodial parent(s), if any:

Name

Residence

Relationship

6. Respondent [check applicable boxes]:

G does not attend school in accord with the provisions of part one of Article 65 of the Education Law

Petition - Family Court Of The State Of New York