New York Codes, Rules and Regulations › Title 22 - JUDICIARY › Subtitle D - Forms › Chapter IV - Forms of the Family Court of the State of New York and Adoption Forms of the Family Court of the State of New York (cf. s205.7) › Subchapter B - Adoption Forms Of The Family Court › Adoption Forms › Form 1-E - Affirmation regarding venue

Current through Register Vol. 46, No. 28, July
					 10, 2024
D.R.L. § 113 Adoption Form 1-E
[This form must be submitted (Affirmation
						Regarding Venue) in cases where the adoption petition was filed before (9/2006)
						a judge other than the judge who heard the most recent Family Court
						proceeding]
FAMILY COURT OF THE STATE OF NEW
						YORK
COUNTY OF
________
In the Matter of the Adoption of Docket
						No.
A Child Whose First Name Is:
						AFFIRMATION
REGARDING VENUE
________
I, [specify name]:,, an attorney duly
						admitted to practice law in the State of New York, affirm the following:
1. I represent [specify]:, the prospective
						adoptive parents in the above-entitled proceeding regarding the adoption of
						[specify child's first name]:
2. Upon information and belief, according
						to [specify agency having custody or guardianship of child or other source of
						information]:
the child was freed for adoption as
						follows [check applicable box(es)]:
a. The child's birth mother:
surrendered her parental rights in a
						judicial surrender executed before Judge [specify]: in Family Court, [specify
						county]: on [specify date]: in Docket # [specify]:
extra-judicial surrender approved by Judge
						[specify]: in Family Court, [specify county]: on [specify date]: in Docket #
						[specify]:
had her parental rights terminated by
						order of Judge [specify]: in Family Court, [specify county]: on [specify date]:
						in Docket # [specify]:
is unknown.
is deceased.
b. The child's birth father or any other
						individual entitled to consent to the adoption:
surrendered his parental rights in a
						judicial surrender executed before Judge [specify]: in Family Court, [specify
						county]: on [specify date]: in Docket # [specify]:
extra-judicial surrender approved by Judge
						[specify]: in Family Court, [specify county]: on [specify date]: in Docket #
						[specify]:
had his parental rights terminated by
						order of Judge [specify]: in Family Court, [specify county]: on [specify date]:
						in Docket # [specify]:
is unknown.
is deceased.
Adoption Form 1-E Page 2
3. Upon information and belief, according
						to [specify agency having custody or guardianship of child or other source of
						information]: the child's most recent permanency hearing was held before
						[specify judge or referee] in Family Court, [specify county]:, on [specify
						date]:
4. This adoption proceeding has been filed
						before this Court for the following reasons [check applicable box(es) and
						explain]:
This Court is more familiar with the facts
						and circumstances regarding permanency planning for, and the needs and best
						interests of, this child, because [specify]:
The child's law guardian [specify]: is
						able to continue to represent the child in this proceeding.
The prospective adoptive parents reside in
						[specify county] and would find it inconvenient to travel to the Family Court
						in [specify county]:
This Court will be able to proceed in this
						matter more expeditiously because [specify]:
Other [specify]:
WHEREFORE, for the reasons stated above, I
						am requesting that this Court retain jurisdiction over this adoption
						proceeding.
______________
Signature of Affirmant
______________
Affirmant's Name (print or type)
________
________
______________
Affirmant's Address and Telephone
						Number