F.C.A.§ 1082 Form 10-26 (Child Protective--Order of Visitation) 8/2010 At a term of the Family Court of the State of New York, held in and for the County of , at New York , on , P R E S E N T: Hon. Judge ________________________________ In the Matter of . Docket No. ORDER OF VISITATION CIN # A Child under Eighteen Years of Age Alleged to be (Abused) (and) (Neglected) by Respondent(s) ________________________________ The Petitioner(s) herein having filed a petition requesting enforcement of the rights of visitation with [specify child(ren)]: , who are related to Petitioner(s) as follow [specify]: And the child(ren) having been “ remanded “ placed in the care of the Commissioner of Social Services of the County of [specify]: , by order of the Court of the County of [specify]: , dated [specify]: [Check if applicable]: And visitation with the child(ren) having been the subject of “ a written agreement, dated [specify]: between Petitioner(s) and [specify]: “ an order of [specify Court and date]: “ a judgment of [specify Court and date]: And the matter having duly come on to be heard before this Court and the Court having determined that enforcement of visitation rights as described in the “ order “ judgment “ agreement [check applicable box]: “ would “ would not endanger the child(ren)'s life or health; NOW, after examination and inquiry into the facts and circumstances of the case and after having the proofs [check if applicable]: “ and testimony, it is hereby [check applicable box]: “ ORDERED that the petition is DENIED; OR “ ORDERED that the petition is GRANTED; (and it is further) American LegalNet, Inc. www.FormsWorkFlow.com Form 10-26 Page 2 [Applicable where petition is GRANTED; check applicable box]: “ ORDERED that the visitation rights described in the above “ written agreement “ order “ judgment shall be enforced; OR “ ORDERED that the following alternative schedule of visitation shall supersede the provisions of the above “ written agreement “ order “ judgment and that visitation shall be held as follows [specify]: (and it is further) “ ORDERED [specify]: ENTER Judge of the Family Court Dated: PURSUANT TO SECTION 1113 OF THE FAMILY COURT ACT, AN APPEAL FROM THIS ORDER MUST BE TAKEN WITHIN 30 DAYS OF RECEIPT OF THE ORDER BY APPELLANT IN COURT, 35 DAYS FROM THE DATE OF MAILING OF THE ORDER TO APPELLANT BY THE CLERK OF COURT, OR 30 DAYS AFTER SERVICE BY A PARTY OR THE ATTORNEY FOR THE CHILD UPON THE APPELLANT, WHICHEVER IS EARLIEST. Check applicable box: 9 Order mailed on [specify date(s) and to whom mailed ]:___________________________ 9 Order received in court on [specify date(s) and to whom given]:_____________________ American LegalNet, Inc. www.FormsWorkFlow.com