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 7 - Report of investigation (private-placement)
D.R.L. § 116 Form 7
(Report of Investigation-
Private-Placement)
12/97
SURROGATE'S COURT OF THE STATE OF NEW YORK
COUNTY OF
________
In the Matter of Adoption of
A Child Whose First Name Is (Docket)(File) No.
REPORT OF
INVESTIGATION
(Private-Placement)
________
TO THE COURT OF THE COUNTY OF ;
Pursuant to the order for investigation dated the day of from the Honorable Judge of the Court, I,, do report that I have investigated the allegations set forth in the petition herein and any statements contained in the affidavits required by the Domestic Relations Law. On the basis of such investigation, I respectfully submit the following report:
1. The marital status, family members and history, religious affiliation, if any, of the adoptive parent(s) and adoptive child are:
;
2. The physical and mental health of the adoptive parent(s) and adoptive child are:
;
3. The adoptive parent(s) have an income of and own the following property:
4. The following fees, compensation or other remuneration have been paid or agreed upon with respect to the placement of the child for adoption:
To natural parent:
To attorney for natural parent:
Form 7 page 2
To agency:
To attorney for agency:
To attorney for adoptive parent:
Other (specify):
5. The adoptive parent(s) (has) (have) not been (a) respondent(s) in any proceeding involving children alleged to be neglected, abandoned, abused, delinquent or in need of supervision except:
;
6. The following other facts relating to the familial, social, emotional and financial circumstances of the adoptive parent(s) may be relevant to a determination of adoption:
Dated:, 19.
______________
Investigator
______________
Petitioner
______________
Print or type name
______________
Signature of Attorney, if any
______________
Attorney's Name (Print or Type)
________
________
______________
Attorney's Address and Telephone Number
