Fill and Sign the Bill of Sale Form New York Child Custody Form Templates

Specify if address, telephone or other identifying information has been ordered to be kept confidential 1pursuant to New York State Domestic Relations Law §§76-h(5), 254 or Family Court Act §154-b. If your health orsafety or that of your child or children would be put at risk by disclosure of your address or other identifyinginformation, you may apply for an address confidentiality order by submitting General Form GF-21. This form isavailable on-line at www.nycourts.gov . DRL Art. 5-A Form UCCJEA-11 (Petition to Enforce Custody or Visitation Order – UCCJEA), 3/2009FAMILY COURT OF THE STATE OF NEW YORKCOUNTY OF.....................................................................................In The Matter of a Proceeding to Enforce a “ Custody “ Visitation Orderunder the Uniform Child Custody Jurisdictionand Enforcement ActDocket No.PetitionerPETITION TO ENFORCE“ CUSTODY “ VISITATIONORDER – UCCJEA -against-Respondent.......................................................................................“ WARNING: THE PURPOSE OF THE HEARING REQUESTED IN THIS PETITION IS TO PUNISH [Specify name]: FOR CONTEMPT OF COURT, WHICH MAY INCLUDE SANCTIONS OF A FINE OR IMPRISONMENT OR BOTH. YOUR FAILURE TO APPEAR IN COURT OR TO MAKE ARRANGEMENTS TO TESTIFY BY TELEPHONE OR OTHER ELECTRONIC MEANS, PURSUANT TO DOMESTIC RELATIONS LAW §75-j, MAY RESULT IN YOUR IMMEDIATE ARREST AND IMPRISONMENT FOR CONTEMPT OF COURT. TO THE FAMILY COURT: The Petitioner respectfully alleges upon information and belief that: 1. Petitioner, , [check applicable box]: “ resides “ is located at [specifyaddress or indicate if ordered to be kept confidential]: 1Petitioner is [specify relationship to child; if foster parent, agency, institution or other relationship, sostate] : . Petitioner seeks to enforce the following order of “ custody “ visitation , a certified copy of which is attached [specify jurisdiction, court and docket or index number]: 2. Respondent , , [check applicable box]: “ resides “ is located at [specifyaddress or indicate if ordered to be kept confidential pursuant to Family Court Act §154-b(2) or DomesticRelations Law §§76-h(5), 254]: Form UCCJEA-11 Page 2 Inapplicable if Petitioner is based at a permanent duty station or has had a permanent 2reassignment of station. Inapplicable if Respondent is based at a permanent duty station or has had a permanent 3reassignment of station.Respondent is [specify relationship to child; if foster parent, agency, institution or other relationship, sostate]:3. The name, present address, and date of birth of each child who is the subject of thisproceeding are as follows [Indicate if address ordered to be kept confidential pursuant to DomesticRelations Law §§76-h(5), 254 or Family Court Act §154-b(2)]: Name Present Address Date of Birth 4. [Applicable when Petitioner and/or Respondent are on active duty or have recentlyreturned from active military service; DELETE if inapplicable]: a. Petitioner [check applicable box]: Q is on active duty, deployed or temporarily assigned to military service as follows [specifytype of service, military branch or National Guard unit, anticipated dates and location of duty and how dutyis likely to affect custody or visitation, if at all]:2 Q returned from active duty, deployment or temporarily assignment to military service asfollows [specify date of return, type of service, military branch or National Guard unit, anticipated datesand location of duty and how return from active duty is likely to affect custody or visitation, if at all]: b. Respondent [check applicable box]: Q is on active duty, deployed or temporarily assigned to military service as follows [specifytype of service, military branch or National Guard unit, anticipated dates and location of duty and how dutyis likely to affect custody or visitation, if at all]:3 Q returned from active duty, deployment or temporarily assignment to military service asfollows [specify date of return, type of service, military branch or National Guard unit, anticipated datesand location of duty and how return from active duty is likely to affect custody or visitation, if at all]: 5. [Applicable where the judgment or order had been entered in conjunction with a NewYork child protective dispositional or permanency hearing order directing custody with a relative orother non-parent, pursuant to Family Court Act §1055-b or §1089-a; delete if inapplicable]: (i) The Gjudgment Gorder was issued in conjunction with the following child protective orpermanency proceeding [specify Family Court, county and docket #]:(ii) The Gjudgment Gorder provided that the following local department of social services[specify]: and the following attorney for the child(ren)[specify]: must benotified and shall be made parties to any subsequent proceedings for modification, enforcement or Form UCCJEA-11 Page 3 See note #1. 4termination of the judgment or order. 6. This order [check applicable box]: “ was issued by a New York State Court. “ has been registered in New York State. [Attach copy of Order or Certification ofRegistration. Note: registration is not required for enforcement]. “ has not been registered in New York State. “ was denied registration in New York State on [specify date]: by [check applicable box]: “ this Court “ another New York State court [specify]: “ is the subject of a pending application for registration in New York State filed on [specifydate]: in [check applicable box]: “ this Court “ another New York State court [specify]:7. This order [check applicable box]:“ has been registered in the following other state, tribal or territorial jurisdiction or country[specify]: [Note: registration is not required for enforcement].“ has not been registered in any other jurisdiction or country.“ was denied registration in the following other state, tribal or territorial jurisdiction or country[specify]:“ is the subject of a pending application for registration in the following other state, tribal orterritorial jurisdiction or country [specify]:8. This order is in effect and has not been vacated, stayed or modified. 9. The name and current address of the person(s) with whom each child resided during the past 4five years are as follows:Name Address Duration Name of Person Current Address of (from/to) With Whom Child the Person With Resided Whom Child Resided 10. Apart from the proceeding that resulted in the issuance of the order sought to be enforcedherein, Petitioner “ has “ has not participated as a “ party “ witness “ other [specify]: inother litigation concerning the custody of the same child(ren) in “ New York State “ Other State or otherjurisdiction [specify]: . If so, specify type of case, capacity ofparticipation, court, location and status of case: 11. [Check applicable box]: “ The following person(s) not party to these proceedings have claimed “ physical custody or“ visitation rights to the child(ren) as follows: “ I know of no person(s) not a party to the proceedings who claim(s) to have custody orvisitation rights with respect to the child(ren) affected by this proceeding. 12. Check applicable box: “ No proceeding has been commenced that could affect this action. Form UCCJEA-11 Page 4 “ The following proceeding(s) have been commenced that could affect this action, [specify jurisdiction, court, docket or index number, type of proceeding and status]: 13. The court that issued the order sought to be enforced identified the following jurisdictionalbasis or bases for its issuance [check applicable box(es)]: “ The child lived in that state or jurisdiction with a parent or person acting as a parentfor at least six consecutive months before the proceeding was commenced. “ The child and at least one parent or person acting as a parent had a significant connection with that state or jurisdiction and that state or jurisdiction has substantialevidence concerning the child’s care, protection, training and personalrelationships. “ All other courts with jurisdiction declined to exercise jurisdiction and the court that issued the order determined that it was the more appropriate forum. “ No court of any other state or jurisdiction would have jurisdiction based upon any ofthe foregoing factors. “ No jurisdictional basis for the order was specified. 14. Respondent violated this order by the following acts [specify violation(s) includingfacts, circumstances and dates]: 15. Because of the Respondent’s violation, Petitioner has incurred the following legalexpenses and costs to date [specify; delete if inapplicable]: 16. [Delete if inapplicable]: This court should issue a warrant requiring the production of thechild because [check applicable box(es)]: “ The child is at imminent risk of serious physical harm, because [specify]: “ The child is at imminent risk of removal from the State of New York because [specify]: 17. Petitioner requests a Temporary Order of Protection pursuant to Family Court Act §655because [specify]: 18. [Applicable where government agency is a party]: The subject child “ is “ is not aNative-American child, who is 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 [give notification date]: 19. No previous application has been made to any court or judge for the relief herein, (except[specify; delete if inapplicable]: ). WHEREFORE, Petitioner requests that this Court issue [check applicable boxes]: “ an order directing Respondent to appear immediately before the Court with the Form UCCJEA-11 Page 5 above-named child(ren); “ a warrant directing law enforcement to pick up the child(ren) and give physical custody to Petitioner or [specify]: “ an order necessary to ensure the safety of the parties and the child(ren) as follows [specify]: “ a temporary order of protection containing the following condition(s) [specify]: “ an order convening an immediate hearing within three court days after the filing ofthis petition to enforce the custody or visitation order. “ an order directing Respondent to pay Petitioner’s attorney’s fees and costs. “ an order [specify]: “ an order providing such other and further relief as this Court may deem just and proper.Dated: _________________________Signature of Petitioner_________________________Petitioner’s Name (print or type) __ Signature of Attorney, if any Attorney’s Name (print or type) Attorney’s Address and Telephone Number VERIFICATIONSTATE OF NEW YORK ) :ss:COUNTY OF ) being duly sworn, says that (s)he is the Petitioner inthe above-named proceeding and that the foregoing petition is true to (his)(her) own knowledge, except as tomatters therein stated to be alleged on information and belief and as to those matters (s)he believes it to be true.__________________________ PetitionerSworn to before me this day of (Deputy) Clerk of the Court Notary Public