New York Codes, Rules and Regulations
Title 22 - JUDICIARY
Subtitle D - Forms
Chapter VII - Surrogate's Court Forms
Subchapter A - Forms Authorized By Section 207.52
Surrogate's Forms
Form G-10A - Petition to close guardianship account (former infant)
SURROGATE'S COURT OF THE STATE OF NEW YORK
COUNTY OF ________
________X
In the Matter of the Guardianship of
PETITION TO CLOSE
GUARDIANSHIP ACCOUNT
(Former Infant)
________ File No. ________
a Former Infant.
________X
TO THE SURROGATE'S COURT OF THE COUNTY OF ________:
1. The name, permanent address and birth date of the petitioner (former infant) as well as the name and permanent address of the guardian of the former infant, are as follows:
Former Infant's Name: ____________
Permanent Address of Former Infant: ____________
Date of Birth: ________
Guardian's Name: ____________
Guardian's Permanent Address: ____________
2. The guardian has custody and control of the following property of the petitioner to which the petitioner is now entitled by reason of having attained the age of eighteen.
The sum of $ ________ deposited in Account No. ____________ in the
_______________
(Name and Address of Depository) with accrued interest.
[Attach current bank statement]
[Attach additional sheets as needed]
3. There are no persons interested in this proceeding other than those hereinabove mentioned.
WHEREFORE petitioner requests that a Decree be entered directing the payment to petitioner (former infant) the property described in paragraph (2) above.
Dated: ________
_______________
Signature of Petitioner (FORMER INFANT)
_______________
Print Name
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G-10A (9/00)
STATE OF NEW YORK)
COUNTY OF ( ________) ss.:
I, the undersigned petitioner being duly sworn, say: That I have read the foregoing petition subscribed by me and know the contents thereof, and that the same is true of my own knowledge, except as to those matters therein stated to be alleged on information and belief and as to those matters I believe it to be true.
_______________
Signature of Petitioner
Sworn to before me this ________
_______________
Print Name
day of ________, ________
________
Notary Public
Commission Expires:
(Affix Notary Stamp or Seal)
Signature of Attorney: ____________
Print Name: ____________
Firm Name: ________Tel. No.: ____________
Address of Attorney: ____________
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