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F.C.A.§1014 Form 10-19 (Child Protective-- Order of Transfer to Criminal Court or Referral to District Attorney) 8/2010 At a term of the Family Court of the State of New York, held in and for the County of , at , New York on , . PR E S E N T: Hon. Judge ................................................................ In the Matter of Docket No. CIN # A Child under Eighteen Years of Age Alleged to be (Abused) (and) ORDER OF (Neglected) by TRANSFER TO CRIMINAL COURT OR REFERRAL TO DISTRICT ATTORNEY Respondent (s) ................................................................ A proceeding having been originated in this Court under Article 10 of the Family Court Act in which allegations have been made that [specify names of child(ren)]: (is) (are) “ abused “ neglected as defined in section 1012 of the Family Court Act, and upon a hearing, it having appeared that the allegations, if sustained, would constitute a violation of the Penal Law of the State of New York in that [specify]: NOW therefore, it is hereby ADJUDGED that the processes of the Family Court are inappropriate or insufficient, and it is ORDERED , that this proceeding be [check applicable box]: “ transferred to the Court of County “ referred to the District Attorney of County; (and it is further) “ ORDERED, that this proceeding in the Family Court , County , is hereby “ continued; “ dismissed; (and it is further) Form 10-19 Page 2 “ ORDERED [specify]: ENTER Judge of the Family Court Dated: PURSUANT TO SECTION 1113 OF THE FAMILY COURT ACT, AN APPEAL FROM THIS ORDER MUST 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 OF COURT, OR 30 DAYS AFTER SERVICE BY A PARTY OR THE ATTORNEY FOR THE CHILD UPON THE APPELLANT, WHICHEVER IS EARLIEST. 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]:_____________________