Fill and Sign the Article 530 Cplorders of Recognizance Bail by What Courts Form

FCA '154-d; CPL ''530.12 (3),(3-a),(3-b) Family Court General Form 5d Criminal Form 5 (Local Criminal Court): 9/2009 County of _____________________________ Petitioner AFFIDAVIT IN SUPPORT OF MODIFICATION OF FAMILY COURT ” ORDER OF PROTECTION ” TEMPORARY ORDER OF PROTECTION Index/Docket # Respondent _______________________________ State of New York ) ): ss: County of ) I, (Petitioner's name):__________________________________, having been duly sworn, depose and state the following under the penalties of perjury: 1. The Family Court, _______________________ County, is not in session at the present time. 2. I filed a petition under [specify article]: _________ of the Family Court Act in Family Court, ____________________ County, on [specify date]: __________. The FamilyCourt issued ” an order of protection ” a temporary order of protection that expires on [specify date]: _____________________. 3. The following criminal, matrimonial or Family Court cases have been filed involving the respondent and me: [Specify type of case, who filed it, the court in which it was filed, the approximate date filed and the present status, if known]: 4. The following additional orders of protection or temporary orders of protection have been issued against the Respondent or against me: [Specify type of case in which the order was issued, persons protected by the order, the court that issued it, the approximate date issued and expiration date,if known]: F am ily C o urt G eneral F o rm 5 d /C rim F o rm 5 P age 2 5. I understand that any modification of the Family Court order issued by this Court shall expire on the date indicated, which shall be not more than four calendar days after its issuance, unless sooner vacated or modified by the Family Court. I understand that the matter will be transferred to the Family Court and that I must appear in Family Court on or before the date indicated. I further understand that I have a right to seek a criminal prosecution of respondent in addition to, or instead of, proceeding in Family Court. 6. The following constitutes good cause for modifying the temporary order of protection or order of protection: [Specify facts and reasons why the existing order is insufficient for the protection of the petitioner, the petitioner's child or children or other members of the petitioner's family orhousehold]: For the reasons stated above, I am requesting that my application for modification of the Family Court Qtemporary order of protection Qorder of protection be granted and that the matter be transferred to the Family Court, ____________________County. False statements in this affidavit are punishable as a class A misdemeanor, pursuant to Penal Law '210.45. _____ Petitioner S w orn to b efore m e th is d ay of _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (JU D G E ): (S U P E R IO R O R D E S K O F F IC E R , P O L IC E D E P A R T M E N T ): (N O T A R Y P U B L IC ): T O C L E R K O F C O U R T : T h is affid avit, togeth er w ith an y m od ified ord er of p rotection or tem porary ord er of p rotection so issu ed , sh all b e tran sm itted forth w it h to th e F am ily C ou rt; if th e affidavit an d ord er a re tran sm itted b y facsim ile or oth er electron ic m ean s, the origin al sh all b e forw ard ed im m ediately th ereafter.