Fill and Sign the Form 5 7a

F.C.A.§ 564 Form 5-7a (Paternity--Order of Filiation--Non-Article 5/5-B Petition) 8/2010 At a term of the Family Court of the State of New York, held in and for the County of , at New Yorkon , . P R E S E N T: Hon. Judge/Support Magistrate .......................................................................................... In the Matter of a Proceeding Docket No. Under Article of the Family Court Act Petitioner, ORDER OF S.S.#: xxxx-xx- FILIATION (Non-Article 5/5-B) -against- Respondent. S.S# : xxxx-xx- .......................................................................................... NOTICE: IF YOU WERE NOT IN COURT FOR THE HEARING AND THIS ORDER WAS ISSUED ON DEFAULT, YOU MAY OBJECT OR CHALLENGE THE ORDER BY FILING A MOTION TO VACATE THE ORDER. IF YOU WERE IN COURT FOR THE HEARING AND THIS ORDER IS ENTERED BY A JUDGE, 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, 30 DAYS AFTER SERVICE BY A PARTY OR THE ATTORNEY FOR THE CHILD UPON THE APPELLANT, OR 35 DAYS FROM THE DATE OF MAILING OF THE ORDER TO APPELLANT BY THE CLERK OF COURT, WHICHEVER IS EARLIEST. IF YOU WERE IN COURT FOR THE HEARING AND THIS ORDER IS ENTERED BY A SUPPORT MAGISTRATE, SPECIFIC WRITTEN OBJECTIONS TO THIS ORDER MAY BE FILED WITH THIS COURT WITHIN 30 DAYS OF THE DATE THE ORDER WAS RECEIVED IN COURT OR BY PERSONAL SERVICE, OR IF THE ORDER WAS RECEIVED BY MAIL, WITHIN 35 DAYS OF THE MAILING OF THE ORDER. Form 5-7a page 2 A petition under Article of the Family Court Act, sworn to on , having been filed in this Court in the above-entitled proceeding in which there is an allegation or statement that is the father of [ insert child’s name and social security number] , a child (who is a party to the proceeding) (who is a subject of the proceeding); and it appearing that the child was born out of wedlock on [insert child’s date of birth] ; and both parents are before the Court; and said father having waived the filing of a petition under Section 523 of the Family Court Act and the right to a hearing under Section 531 of said Act; and the court being satisfied as to the paternity of the child from the testimony or sworn statements of the parties, NOW, therefore, after examination and inquiry into the facts and circumstances of the case and after hearing the proofs and testimony offered in relation thereto; it is ADJUDGED AND DECLARED that the above-named is the father of [child's name]. [Check box if applicable]: GAND IT IS FURTHER ORDERED THAT [specify]: ENTER _____________________________________ Judge of the Family Court/Support Magistrate 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]:_____________________