New York Codes, Rules and Regulations
Title 22 - JUDICIARY
Subtitle D - Forms
Chapter VII - Surrogate's Court Forms
Subchapter B - Adoption Forms Of The Surrogate's Court
Adoption Forms
Form 12 - Order removing child from adoptive home
D.R.L. § 116(2) Form 12
(Order Removing Child From
Adoptive Home)
12/97
At a term of the Surrogate's Court of the
State of New York, held in and for the
County of ,
at New York
on, 19.
PRESENT:
Hon.
Judge
________
In the Matter of the Adoption of (Docket) (File) No.
A Child Whose First Name Is
ORDER REMOVING
CHILD FROM
ADOPTIVE HOME
________
, the adoptive child above named having been
placed for adoption on or about, 19, with the petitioner(s) herein, and a petition having been duly filed in this Court praying for an order of adoption pursuant to section 116 of the Domestic Relations Law; and
This Court having on the day of, 19, issued an order of investigation designating
to examine into the allegations set forth in the petition and to make a written report of the investigation; and the investigator having duly made and submitted a written report of investigation dated, 19 ; and it appearing from the report that good cause exists for the removal of the adoptive child from the home of said petitioner(s); and
The petitioner(s) having been ordered to show cause why the adoptive child should not be removed from the home of said petitioner(s); and due notice of this proceeding having been given to (and
);
and the Court having taken proof of the facts shown by the investigations and the Court being satisfied that the welfare of the adoptive child requires that (he) (she) be removed from the home of the petitioner(s);
Form 12 page 2
Now, therefore, it is hereby
ORDERED that, the adoptive child, be and (he) (she) hereby is removed from the home of (and) and is (transferred to the Family Court) (returned to) (placed with [specify]:
); (and it is further)
(ORDERED that a copy of this order be served upon
, an authorized agency.)
ENTER
______________
(SURROGATE)
Dated: 19.
