Fill and Sign the Family Court Article 4 Part 1jurisdiction Dutiesny Law Form

Note: This form is not to be used for violations of orders General Form 8a of child support issued pursuant to Articles 4, 5 or (Petition-Violation5-B or orders of disposition issued pursuant to Articles of Court Order) 3, 7 or 10 of the Family Court Act. 4/2011 FAMILY COURT OF THE STATE OF NEW YORKCOUNTY OF............................................................................. In the Matter of a Proceeding under Article of the Family Court Act Docket No. Petitioner, - against - PETITION(Violation of Respondent. Court Order) .............................................................................. . 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 MAY RESULT IN YOUR IMMEDIATE ARREST AND IMPRISONMENT FOR CONTEMPT OF COURT. TO TH E FA M ILY C O U RT: The undersigned Petitioner Respondent respectfully shows that: 1. a. Petitioner, , [check applicable box]: “ resides “ is located at [specify address or indicate if ordered to be kept confidential pursuant to Family Court Act §154-b(2) or Domestic Relations Law §254]: b. Respondent , , [check applicable box]: “ resides “ is located at [specify address or indicate if ordered to be confidential, pursuant to Family Court Act §154-b(2) or Domestic Relations Law §254]: 2. .By order of this Court, dated , , the Petitioner Respondent was directed to 3. (Upon information and belief) a. Petitioner Respondent has failed to obey the Order of this Court in that [specify]: b. This failure was was not willful. 4. The following child(ren) (is)(are) the subject(s) of the proceeding resulting in the issuance of General Form 8a Page 2 the Order alleged to have been violated : Name Date of Birth Address 1 5. Petitioner Respondent has defeated, impaired, impeded or prejudiced the rights or remedies of Petitioner Respondent , in that [specify]: 6. No previous application has been made to any court or judge for the relief herein requested (except [specify;]: WHEREFORE, Petitioner Respondent that the Petitioner Respondent be dealt with in accordance with applicable provisions of law. Dated: Signature of Petitioner Respondent Print or type name Signature of Attorney, if any Attorney’s Name (Print or Type) Attorney’s Address and Telephone Number VERIFICATION STATE OF NEW YORK ) ):SS.: COUNTY OF ) being duly sworn, says that (s)he is the Petitioner Respondent in the above-named proceeding and that the foregoing petition is true to (his) (her) own knowledge, except as to matters therein stated to be alleged on information and belief and as to those matters (s)he believes it to be true. Petitioner Respondent Sworn to before me this day of . (Deputy) Clerk of the CourtNotary Public U nless the C o urt has o rd ered the ad d ress to b e co nf id ential o n the gro und that d isclo sure w o uld p o se an 1 unreaso nab le health o r safety risk. S ee F am ily C o urt A ct § 1 5 4 -b ; F o rm 2 1 , 2 1 a (o n-line at ww w .nyco urts.go v).