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-D - Notice (denial or withdrawal of application; removal of child)
D.R.L. § 1115-C Form 21-D
S.C.P.A. § 1725 (Temporary
Guardianship)
12/97
SURROGATE'S COURT OF THE STATE OF NEW YORK
COUNTY OF
________
In the Matter of the Temporary (Docket)(File) No.
Guardianship of A Child Whose
First Name is NOTICE
(Denial or Withdrawal of
Application; Removal of
Child)
________
TO:
PLEASE TAKE NOTICE that on the day of, 19 :
() the petition of for an order of temporary
guardianship was denied.
() the petition for adoption filed by has been
(iv), CPLR 315 (Order of Publication
() the child,, has been removed from the physical
custody of.
() the order dated the day of, 19, granting temporary
guardianship of the child,, to
has expired without the entry of a final order of adoption.
The law requires this notice to be sent to you. You may wish to consult a lawyer about your legal rights at this time.
Dated:, 19.
______________
CLERK OF THE COURT