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New York Social Services Law 384 Guardianship and Custody

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AFFIDAVIT OF PROVIDER OF SUPPORTIVE COUNSELING – EXTRA-JUDICIAL SURRENDER OF CHILD IN FOSTER CARE

Soc. Serv. Law § 383-c(4)(c)

Form SURR-5-a

(Extra- Judicial Surrender of Child in Foster Care--
Affidavit of Provider of Supportive Counseling)¹

(9/2006)

FAMILY COURT OF THE STATE OF NEW YORK

COUNTY OF

In the Matter of the Application for

Approval of a Surrender Instrument Concerning

Docket No.

CIN #

Pursuant to Section 383-c of the Social Services Law

STATE OF NEW YORK )

COUNTY OF )ss.:

)

I, , having been duly sworn, deposes and states the following:

1. I am employed by

2. I was not the authorized agency employee witness to the extra-judicial surrender of

by

3. Upon information and belief, on ,

was offered supportive counseling regarding the extra-judicial surrender of and on :

accepted did not accept the offer of supportive counseling.

4. [Check applicable box or delete inapplicable provision]:

On , I provided supportive counseling for as follows [describe, including nature of counseling]:

Supportive counseling was not provided to the person executing the surrender.

Signature of Provider of Supportive Counseling

Sworn to before me this day of ,

Notary Public

(Deputy) Clerk of Court

¹ The provider of supportive counseling may not be the employee-witness to the extra-judicial surrender.

See 18 NYCRR §421.6.

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Overview of New York Social Services Law 384 and guardianship uses

New York Social Services Law 384 establishes procedures used by state and local social services agencies and family courts when children require temporary or longer-term custody or guardianship for protection, placement, or care. The provision frames agency responsibilities, notice and reporting obligations, and coordination with family court procedures; it interacts with child welfare, foster care, and permanency planning systems. Practitioners use this statute alongside applicable regulations and court rules to determine placement authority, documentation requirements, and the sequence of hearings that protect a child's safety while preserving due process rights for parents and guardians.

Why understanding Section 384 matters for child welfare and legal teams

Knowing how New York Social Services Law 384 applies ensures consistent documentation, timely hearings, and defensible custody or guardianship actions while protecting child safety and parental rights.

Why understanding Section 384 matters for child welfare and legal teams

Who typically completes or relies on these guardianship and custody records

Social workers, attorneys, family court clerks, guardians ad litem, and agency supervisors commonly prepare or review documents governed by this statute.

  • Social services caseworkers preparing custody referrals and placement records for family court review.
  • Family law attorneys and guardians ad litem submitting evidence, declarations, or motions under agency case timelines.
  • Agency supervisors and compliance officers who track statutory notice, reporting, and documentation obligations.

Primary roles who sign or approve these forms

Agency Caseworker

A social services caseworker or supervisor completes factual statements, documents placement decisions, and signs attestations. Their recordkeeping must reflect investigative steps, attempts to notify relatives, and any immediate safety measures taken on behalf of the child.

Family Court Attorney

An attorney filing petitions or appearing in family court signs legal pleadings, submits supporting affidavits, and confirms procedural compliance. Counsel often coordinates with agency staff to ensure evidence aligns with court standards and statutory requirements.

Essential data elements to include on custody and guardianship forms

Child Name: Full legal name
Date of Birth: MM/DD/YYYY
Guardian/Parent: Full legal name
Case ID: Agency case number
Placement Address: Street, city, state, ZIP
Effective Date: MM/DD/YYYY

Risks and legal consequences of incomplete or incorrect filings

Delayed hearings: Court timeline impacts
Placement challenges: Risk to child safety
Administrative sanctions: Agency oversight action
Evidentiary exclusion: Statements may be excluded
Privilege issues: Confidentiality breaches
Reversal risk: Orders may be vacated

Common preparation pitfalls to avoid

  • Using inconsistent names or misspelled legal names that create mismatches with court or agency records and delay processing.
  • Failing to capture accurate effective dates or timelines, which complicates permanency hearings and statute-driven review periods.
  • Omitting supporting documentation such as police reports, medical records, or placement notices required for court adjudication.
  • Neglecting to record who provided consent or notice, making it harder to demonstrate procedural compliance during appeals or audits.

Step-by-step: preparing a Social Services Law 384 custody or guardianship filing

Follow a consistent sequence: gather facts, confirm identity, attach evidence, obtain approvals, and file with the appropriate court or agency.

  • 01
    Gather facts: Collect reports, dates, and contact details
  • 02
    Confirm identity: Match names to ID and case number
  • 03
    Attach evidence: Medical, police, and placement documents
  • 04
    File & track: Submit to court and retain filing receipt

Typical routing and processing flow for custody records

Documents move from caseworker draft to supervisor review, then to legal counsel and finally to family court or agency records for hearing and disposition.

  • Drafting: Caseworker prepares initial statement and evidence list
  • Supervisory review: Supervisor verifies procedural completeness
  • Legal review: Attorney confirms legal sufficiency for filing
  • Filing: Submit to family court or agency registry with proof

Core components of a professional Section 384 guardianship or custody submission

A complete submission blends factual narrative, statutory references, attachments, and attestations. Each element supports the agency’s position and the court’s ability to review safety and permanency needs.

Case Narrative

Clear, chronological summary of observations and decisions that explains why temporary custody or guardianship measures were considered necessary and how agency protocols were followed.

Statutory Basis

Citation to the controlling legal authority, including New York Social Services Law 384 and any relevant regulatory provisions or court rules relied on to justify the filing.

Supporting Evidence

Attachments such as incident reports, medical records, school reports, or police documentation that corroborate statements in the narrative and establish immediate safety needs.

Notices and Service

Documentation of attempts to notify parents, relatives, or guardians, including dates, methods used, and outcomes required for due process and agency accountability.

Signatures and Attestations

Signed affidavits or declarations from caseworkers and supervisors affirming the accuracy of the record and compliance with internal procedures and statutory obligations.

Disposition Plan

Proposed placement, reunification steps, or permanency plan that outlines next steps and timelines for review hearings or agency follow-up.

How to configure a digital workflow for custody and guardianship submissions

Set up role-based routing, required fields, and secure attachments before initiating a signing or filing workflow.

Field Configuration
Required fields Mark ID, DOB, case number as mandatory
Signer order Caseworker -> Supervisor -> Attorney
Authentication Use email + SMS code for signers
Attach docs Require PDF attachments for reports

Digital signing, security, and integration considerations

Choose an e-signature platform that supports audit trails, strong authentication, and secure storage for sensitive child welfare records.

  • Authentication: Email with SMS code or two-factor
  • Audit Trail: IP, timestamp, and action log
  • File formats: PDF/A or PDF for court compatibility

Ensure any e-signature solution complies with ESIGN (15 U.S.C. §7001) and New York’s electronic records rules, and that the vendor can sign a BAA where HIPAA applies.

Timing considerations commonly associated with custody filings

Schedules for emergency placement, temporary orders, and review hearings differ by agency and county; act promptly to meet local timeframes.

Emergency Actions:

Immediate protective measures taken pending review

Temporary Orders:

Court issues interim custody or placement orders

Review Hearings:

Scheduled to reassess placement and permanency

Notice Deadlines:

Prompt attempts to notify parents and relatives are required

Appeal Periods:

Timeframes for challenging orders vary by court

Practical tips for accurate, defensible custody and guardianship records

Adopt consistent templates, version control, and reviewer checklists to reduce errors and support court review.

Use standardized templates
Standard templates ensure required fields are completed uniformly across cases, simplify supervisory review, and reduce omission-related delays.
Record verification steps
Log identity checks, contact attempts, and document sources. Verified chains of custody for evidence increase credibility in court proceedings.
Secure attachments
Attach final PDFs rather than editable files. Maintain an audit trail that records who uploaded, viewed, and signed each document.
Coordinate legal review
Engage counsel early for filings that seek emergency orders or invoke complex statutory questions to avoid avoidable procedural defects.

Comparing common e-signature providers for custody and guardianship workflows

Select an e-signature vendor that meets authentication, audit trail, and any applicable HIPAA or court-admissibility requirements; vendor pricing models vary.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial, no credit card required Varies by plan Varies by plan Varies by plan Varies by plan
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Real-world scenarios illustrating typical use

Two illustrative cases show how agencies and counsel apply Section 384 in practice.

Child Protection Referral

An intake social worker documents immediate safety concerns and requests a temporary custody order.

  • Evidence includes medical and police reports.
  • The combined record, signed by supervisor and counsel, supported a swift temporary placement and scheduled review hearing to establish long-term plans.

Relative Guardianship Filing

A relative seeks guardianship where parental capacity is in question.

  • Caseworker gathers kinship and background checks.
  • Detailed documentation and consistent signatures helped the court evaluate suitability and issue a guardianship order that prioritized stability for the child.

Frequently asked questions about New York Social Services Law 384 filings

Answers to common procedural and e-signature questions when preparing custody or guardianship records.


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