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F.C.A.§§ 301.2, 322.1Form 3-16(Juvenile Delinquency–Order Extending Time forExamination to DetermineCapacity) 8/2010At a term of the Family court of the state of New York held in and for thecounty of ,atNew York, onP R E S E N T:Hon.Judge...............................................................................In the Matter ofDocket No.A Person Alleged to be aORDER EXTENDING TIME Juvenile Delinquent,FOR EXAMINATION TO DETERMINE CAPACITYRespondent....................................................................................A petition under article 3 of the Family Court Act, sworn to on , , having beenfiled in this Court in the above-entitled proceeding alleging that Respondent is a juvenile delinquent,and an order dated , , having been duly entered by this court direction an examination todetermine whether Respondent is an incapacitated person as defined in subdivision 13 of section 301.2of the Family Court Act and further directing that an examination report be filed with this Court by , ; andNotice having been duly given to Respondent, (Respondent's parent(s)) (the person legally responsible for the child’s care) and counsel for Respondent of an application to extend the period for filing the examination report; andRespondent (having appeared by counsel), (Respondent's parent(s)) (the person legally responsible for the child's care) (having appeared in answer to the application) ; and consented to theapplication); and Form 3-16 page 2Special circumstances having been shown to exist in that; it is thereforeADJUDGED that a longer period is necessary to complete the examination and report; and it isORDERED that the time for filing of the examination report is hereby extended to and including , .PURSUANT TO SECTION 1113 OF THE FAMILY COURT ACT, AN APPEAL FROM THIS ORDERMUST BE TAKEN WITHIN 30 DAYS OF RECEIPT OF THE ORDER BY APPELLANT IN COURT,35 DAYS FROM THE DATE OF MAILING OF THE ORDER TO APPELLANT BY THE CLERK OFCOURT, OR 30 DAYS AFTER SERVICE BY A PARTY OR THE ATTORNEY FOR THE CHILDUPON THE APPELLANT, WHICHEVER IS EARLIEST. ENTER_____________________________________ Judge of the Family Court Dated: , . Check applicable box: 9 Order mailed on [specify date(s) and to whom mailed ]:___________________________ 9 Order received in court on [specify date(s) and to whom given]:_____________________