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)

Universal Citation: 22 NY Comp Codes Rules and Regs ยง 21-D
Current through Register Vol. 46, No. 12, March 20, 2024

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

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