Fill and Sign the Form Uccjea 10

DRL Art. 5-A Form UCCJEA-10 (Order on Petition to Modify Custody or Visitation Order – UCCJEA), 8/2010At a term of the Family Court of theState of New York held in and for the County of ,at New Yorkon , .PRESENT:Hon. Judge...................................................................................In The Matter of a Proceeding to Modify a ❑ Custody ❑ Visitation Orderunder the Uniform Child Custody Jurisdictionand Enforcement ActDocket No.❑ FINAL ORDER❑ TEMPORARY ORDER PetitionerON PETITION TOMODIFY ORDER OF❑ CUSTODY ❑ VISITATION -against-– UCCJEARespondent.......................................................................................The Petitioner herein having filed a petition on [specify date]: , pursuant to theUniform Child Custody Jurisdiction and Enforcement Act [Domestic Relations Law Art. 5-A], requestingan order modifying an order of ❑custody ❑ visitation of the following minor children [list each child asfollows]: Name of Child: Date of Birth: Address1 And Respondent having appeared before this Court, either in person or by telephone, audiovisualor other electronic means, to answer the petition, having been advised by the Court of the right to counsel, and having ❑ admitted ❑ denied the allegations of the petition;[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]: And since the judgment order was issued in conjunction with the following childprotective or permanency proceeding [specify Family Court, county and docket #]:and provided that the following local department of social services [specify]: and the1 Unless the Court has ordered the address to be kept confidential pursuant to New York State DomesticRelations Law §§76-h(5), 254 or Family Court Act §154-b. . Form UCCJEA-10 Page 2following attorney for the child(ren)[specify]: must be notified and made parties toany subsequent proceedings for modification of the judgment or order: the department of social services was so notified and did did not appear; and the attorney for the children was so notified and did did not appear; [Required in cases involving Native-American children, where government agency is aparty; check if applicable]:❑ And the following having been duly notified [check applicable box(es)]: ❑ parent/custodian ❑ tribe/nation ❑ United States Secretary of the Interior; And the tribe/nation having: ❑ appeared and participated as a party; ❑ appeared and declined to assume jurisdiction; ❑ appeared and requested transfer of jurisdiction; ❑ not appeared; [ Applicable to cases where Petitioner is a relative or other non-parent and where hearingon modification petition was consolidated with child protective dispositional or permanency hearing,pursuant to F.C.A. §§1055-b or 1089-a; delete if inapplicable]:This Court finds that: Termination of the order placing or remanding the child(ren) pursuant to Article 10 or 10-A ofthe Family Court Act will will not not jeopardize the child(ren)’s safety and is is not in the bestinterests of the child(ren). The child(ren)’s birth mother has has not consented to the award of custody to thePetitioner. If not, the following extraordinary circumstances support Petitioner’s standing to seek custodyof the child(ren) [specify]: The child’s legally-established birth father has has not consented to the award of custodyto the Petitioner. If not, the following extraordinary circumstances support Petitioner’s standing to seekcustody of the child(ren) [specify]: The child has been living with the following foster parent(s)[specify]:for a period in excess of one year, who has/have has/have not consented to the award of custody tothe Petitioner. The local department of social services, the petitioner in the related child abuse or neglect permanency proceeding has has not consented to the award of custody to the Petitioner. The attorney for the child(ren) [specify]: in the related child abuse or neglect permanency proceeding has has not consented to the award of custody tothe Petitioner. [Check applicable box(es)]: And the Court having searched the statewide registry of orders of protection, the sex offenderregistry and the Family Court’s warrant and child protective records, and having notified the attorneys forthe parties and for the child [check if applicable]: and the following self-represented party or parties Form UCCJEA-10 Page 3[specify]: of the results of these searches; And the Court having considered and relied upon the following results of these searches inmaking this decision [specify; if no results found, so indicate]:[Applicable to TEMPORARY orders only]: And the Court, having dispensed with thesearch of the statewide registry of orders of protection, the sex offender registry and the Family Court’swarrant and child protective records because these databases had been reviewed within the past 90 days;[Applicable where a party had made an allegation of domestic violence or child abuse; findingsmust be stated on the record, included in a written decision OR included in this order; checkapplicable box]: And the Court having explained its findings on alleged domestic violence or child abuse on the record; And the Court having issued a written decision containing its findings on alleged domestic violence or child abuse; And the Court having found that the allegation that [specify party]:had committed domestic violence or child abuse against [specify party or child(ren)]: was was not proven by a preponderance of the evidence, and having considered the effect of suchdomestic violence or child abuse upon the best interests of the child(ren) and relevant facts andcircumstances as follows in making this order [specify how findings, facts and circumstances werefactored into this Order]: And the matter having duly come on to be heard before this Court;NOW, after examination and inquiry into the facts and circumstances of the case and afterhearing the proofs and testimony offered in relation thereto; it is herebyADJUDGED that [check applicable box(es)]:1. ❑ This Court has jurisdiction to modify the child custody or visitation order issued by[specify state or other jurisdiction, index or docket number and date]:on the following grounds [check applicable box(es)]: ❑ This Court has jurisdiction to make an initial determination of custody or visitationand [check at least one box]:❑ the court of the other state has determined that it no longer has exclusive,continuing jurisdiction;❑ the court of the other state has determined that a court of this State would be amore convenient forum;❑ a court of the other state has determined that the child, the child’s parents andany other person acting as a parent do not presently reside in the other state;❑ a court of New York State has determined that the child, the child’s parents andany other person acting as a parent do not presently reside in the other state; ❑ This Court has determined that the other state no longer has exclusive continuing jurisdiction and this Court has jurisdiction to modify the order because [check applicable box(es)]:❑ Neither the child, the child’s parents nor any other person acting as a parent Form UCCJEA-10 Page 4presently reside in the other state;❑ New York State has been the home state of the child for at least six months asof the date of this order;❑ New York State would be a more convenient forum based upon the followingfactors [specify]:OR ❑ This Court does not have jurisdiction to modify the order.2. [Applicable where temporary, emergency order is issued]: ❑ This Court has jurisdiction tomodify the order on a temporary, emergency basis, pursuant to Domestic Relations Law §76-c,because the child is presently in this State and [check one or both boxes]: ❑ the child has been abandoned; and/or❑ it is necessary in an emergency to protect the child, a sibling or parent of the child. 3. Petitioner incurred the following attorneys’ fees and expenses in prosecuting this action[specify]: AND IT IS THEREFORE ORDERED that [check applicable box]:❑ The Petition to Modify is GRANTED and the order of custody or visitation shall bemodified as follows [specify]:❑ The Petition to Modify is GRANTED solely on a temporary, emergency basis asfollows [specify]:This temporary, emergency order shall remain in effect until an order is obtained fromanother court having jurisdiction to modify the order of custody or visitation pursuant toSection 76-b of the Domestic Relations Law. This temporary, emergency order shallbecome final if this State becomes the home state of the child(ren) and if no child custodyproceeding is commenced in a state having jurisdiction to modify the order of custody orvisitation pursuant to DRL §76-b. [Check box if applicable]: ❑ Because the child(ren) is/are in imminent risk of harm, thisorder shall remain in effect until another court having jurisdiction to modify the order ofcustody or visitation pursuant to Domestic Relations Law §76-b has taken steps to assurethe protection of the child(ren).OR❑ The Petition to Modify is DENIED and is hereby dismissed. This dismissal is withoutprejudice to any remedies, if any, that Petitioner may have in another state or other jurisdiction;and it is further[Applicable to cases involving a party or parties in the military; DELETE IF INAPPLICABLE]: ORDERED that, since Petitioner Respondent is on active duty, deployed ortemporarily assigned to military service and since such service affects such party’s ability to actas a joint or primary custodian of the child(ren), the return of such party from such active dutyshall constitute a substantial change of circumstances sufficient to entitle such party to a reviewof this Order for possible modification if in the child(ren)’s best interests, unless the parties and Form UCCJEA-10 Page 5child(ren)’s attorney have otherwise stipulated or agreed; and it is further ORDERED that during the period of active military service, deployment or temporaryassignment, the party on such duty shall be permitted the following contact and visitation with thechild [specify, including electronic communication and visitation during military leaves]: ; and it is further [Applicable to cases where hearing on modification petition was consolidated withchild protective dispositional or permanency hearing, pursuant to F.C.A. §§1055-b or 1089-a; delete if inapplicable]: ORDERED that the following local department of social services [specify]:and the following attorney for the child(ren)[specify]: shall be notified andshall be made parties to any subsequent proceedings for modification, enforcement or terminationof the Order; and it is furtherORDERED that the Respondent pay the Petitioner the following fees and costs inconnection with this proceeding [specify]:; and it is further[Applicable in cases involving Native-American child(ren) where governmentagency is a party; check box, if applicable]:❑ ORDERED that the following should be notified of this proceeding [specify]:the ❑ custodian of the child; ❑ tribe/nation; ❑ United States Secretary of the Interior ❑ ORDERED that in light of the assumption of jurisdiction by the tribe/nation, this petition is DISMISSED WITHOUT PREJUDICE; (and it is further)ORDERED that ENTER _____________________________________Judge of the Family Court Dated: , . 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.Check applicable box: ☐ Order mailed on [specify date(s) and to whom mailed ]:__________________________ ☐ Order received in court on [specify date(s) and to whom given]:____________________