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 A - Forms Authorized by Section 205.7 › Surrender Forms › Form SURR-1 - Notice of proceeding for approval of judicial or extra-judicial surrender instrument

Current through Register Vol. 46, No. 28, July
					 10, 2024
S.S.L. §§ 383-c, 384, 384-c Form
						SURR-1
(Surrender--Notice of Proceeding
						for
FAMILY COURT OF THE STATE OF NEW YORK
						Approval of Judicial or Extra-judicial
COUNTY OF Surrender Instrument)
(9/2006)
In the Matter of the Application for
						Approval Docket No.
of a Surrender Instrument Pursuant to
						Sections
383-c or 384 of the Social Services Law
						Concerning NOTICE OF PROCEEDING FOR
APPROVAL OF
CIN# JUDICIAL EXTRA-JUDICIAL
Child's Name: SURRENDER INSTRUMENT
Date of Birth:
TO:
PLEASE TAKE NOTICE that the annexed
						petition requesting approval of an instrument of surrender concerning the
						above-named child has been presented to the Family Court of the State of New
						York, County, located at [specify address]: and that a hearing on the petition
						will be held on [specify date and time]: at which time you will have an
						opportunity to be heard.
PLEASE TAKE FURTHER NOTICE that you have
						the right to be represented by a lawyer and, if you are a custodial or
						non-custodial parent, guardian, grandparent, foster parent or other person
						having physical or legal custody of the above-named child and the Court finds
						that you are unable to pay for a lawyer, you have the right to have a lawyer
						assigned by the Court.
FAILURE TO APPEAR MAY RESULT, WITHOUT
						FURTHER NOTICE, IN COURT APPROVAL OF THE SURRENDER INSTRUMENT AND TRANSFER OF
						CUSTODY AND GUARDIANSHIP OF THE CHILD TO A SOCIAL SERVICES OFFICIAL OR
						AUTHORIZED AGENCY FOR THE PURPOSE OF ADOPTION.
NOTICE TO ADJUDICATED, ACKNOWLEDGED OR
						IDENTIFIED FATHERS, pursuant to Social Services Law § 384-c:[FN1] You have
						a right to appear to present evidence to the Family Court relevant to the best
						interests of the child. Your failure to appear will be considered a denial of
						your interest in the child and may result, without further notice, in court
						approval of the surrender instrument and transfer of custody and guardianship
						of the child to a social services official or authorized agency for the
						purposes of adoption.
Dated:
_______________
Name of Attorney(s)
_______________
Attorney(s) for Petitioner:
_______________
Mailing Address
_______________
Telephone Number
[FN1] This notice paragraph applies to you
						IF you have: (i) been adjudicated the father by a court in New York State; (ii)
						been adjudicated the father elsewhere by a court order that has been filed with
						the national putative father registry; (iii) filed a timely notice of intent to
						claim paternity and have not revoked it; (iv) been identified as the father in
						the child's birth certificate or in a sworn written statement by the child's
						mother; (v) been openly living with the child's mother as the child's parent
						when the court proceeding was begun or the child was placed with the authorized
						agency; (vi) been married to the child's mother within six months after the
						child's birth and before execution of the surrender instrument; or (vii) filed
						an acknowledgment of paternity with the national putative father
						registry.