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-10B - Petition to close guardianship account (guardian)
SURROGATE'S COURT OF THE STATE OF NEW YORK
COUNTY OF ________
________X
In the Matter of the Guardianship of
PETITION TO CLOSE GUARDIANSHIP
ACCOUNT (Guardian)
File No. ________
a Former Infant.
________ X
TO THE SURROGATE'S COURT OF THE COUNTY OF ________:
1. The name and permanent address and birth date of the petitioner (guardian) and the name and permanent address and birthdate of the former infant, are as follows:
Name of guardian: ________ Phone Number: ____________
Permanent Address: ____________
Relationship to former infant: ____________
Name of former infant: ____________
Permanent Address: ____________
Date of Birth: ________
2. The guardian has custody and control of the following property to which the former infant 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. I have informally accounted to the former infant whose consent to this petition is submitted herewith.
4. There are no persons interested in this proceeding other than those hereinabove mentioned.
WHEREFORE, petitioner requests a decree directing and authorizing payment to the former infant of the property abovementioned, and for such other relief as may be proper.
Dated: ________
_______________
Signature of Petitioner
_______________
Print Name
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)
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G-10B (9/00)
CONSENT OF FORMER INFANT
I, ____________, residing at ________
do hereby state:
I hereby join in the within petition and consent to the relief requested.
________, as guardian, has informally accounted to me for the administration of all property which was received by said guardian and I hereby request that said guardian be directed to turn over to me the balance of all property mentioned in the annexed petition.
Dated: ________
_______________
Signature of Former Infant
_______________
Print Name
STATE OF NEW YORK ________)
COUNTY OF ( ________) ss.:
On the ________ day of ________, ________, before me personally came ________, to me known to be the person described in and who executed the foregoing instrument. Such person duly swore to such instrument before me and duly acknowledged that ________executed the same.
________
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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