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 21-B - Order (temporary guardianship of the person)
D.R.L. § 115-c Form 21-B
S.C.P.A. § 1725 (Temporary
Guardianship)
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 Temporary (Docket) (File) No.
Guardianship of A Child Whose
First Name is ORDER
(Temporary
Guardianship
of the Person)
________
Upon reading and filing the petition herein duly verified on applying for (temporary guardianship of, a child placed for adoption,) (an order approving the adoption of, an adoptive child) and it appearing that the child will be residing with the Petitioner(s) and that Petitioner(s) intend to file for adoption of the child within 45 days of the execution of the consent to the adoption of the child, and the Court having inquired of the statewide central register of child abuse and maltreatment and having been informed that the (child) (Petitioner(s)) (is)(are)(not) a subject of or another person named in an indicated report filed with such register as such terms are defined in section 412 of the Social Services Law, and the Court having given due consideration to any information contained therein,
And it appearing further it is (not) in the best interests of the child to grant said petition
NOW therefore, it is hereby
Form 21-B page 2
(ORDERED that said application for temporary guardianship is granted; and it is further
ORDERED that be appointed temporary guardian(s) of the person
of : and it is further
ORDERED that this order shall expire on or the date a final order of adoption is entered, whichever is sooner.)
(ORDERED, that said application for temporary guardianship is denied;) (and it is further)
(ORDERED that the proceeding herein be continued for further investigation;) (and it is further)
(ORDERED that upon notice to, the Petitioner(s)
shall appear on the day of, 19, at to show cause why the child should not be removed from their home;)
ENTER
______________
(Surrogate)
Dated:, 19.