F.C.A. §§ 1027, 1028 Form 10-2b (Child Protective­Order Terminating Remand) (6/2016) 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 FAMILY FILE #: CIN # A Child under the Age of Eighteen Alleged to be "Abused "Neglected by Respondent(s). An order, dated [specify]: , having been entered directing that [specify]: , a child under the age of eighteen be remanded to {specify]: pending determination of the above-entitled proceeding, NOW therefore, it is hereby ORDERED that the order of remand is hereby terminated; and it is further " ORDERED that the above-named child be released to [specify]: , [check applicable box]: " Respondent parent(s) [specify]: " Non-respondent parent(s)[specify]: " Legal custodian(s) or guardian(s)[specify]: OR " ORDERED that the above-named child is placed temporarily in the custody of the following relative(s) or other suitable person(s) [specify]: OR " ORDERED that, pursuant to a petition filed under Article 6 of the Family Court Act, Docket # [specify]: , the child(ren) (is) (are) placed in the temporary custody of the following non-respondent parent [specify]: ; and it is further [Applicable to release to Respondent parent(s)]: " ORDERED that the release to the Respondent parent be under the supervision of [specify]: [Applicable to release to Non-respondent parent(s) or legal custodian(s) or guardian(s) or temporary custody with relative or other suitable person]: " ORDERED that, during the period of temporary release or custody, the non-respondent parent(s), legal custodian(s) or guardian(s), relative(s) or other suitable person(s) shall submit to the jurisdiction of the Court with respect to the child and shall cooperate with respect to making the American LegalNet, Inc. www.FormsWorkFlow.com Docket No. ORDER TERMINATING REMAND child(ren) available for court-ordered visitation with Respondents, siblings and others, appointments with the child(ren)'s) attorneys and clinicians and other individuals or programs providing services to the children, visits (including home visits) by the child protective agency " and the following additional direction(s) [specify]: pending further proceedings herein; (and it is further) " ORDERED that, during the period of release or temporary custody, as applicable, the individual to whom the child(ren) have been released or with whom the child(ren) have been placed into temporary custody under this Order may [check applicable box(es)]: " enroll the child(ren) in public school in the applicable school district and, upon verifying the Order and that the individual resides within the district, such district shall enroll the child(ren); " enroll the child(ren) in their employer-based health insurance plan with the same rights as child(ren) for whom the individual is the legal guardian or custodian; and " make decisions and provide any necessary consents regarding the child(ren)'s: " protection " education " care and control " physical custody " health and medical needs, provided that this Order does not limit any rights of the child(ren) to consent to medical care under applicable laws. " AND IT IS FURTHER ORDERED that, during the period of temporary release or temporary custody, as applicable, the child protective agency, social services official or duly authorized agency shall provide the following services or assistance to the child(ren) and their family, pursuant to section 1015-a of the Family Court Act [specify]:1 " ORDERED that 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: " Order mailed on [specify date(s) and to whom mailed]: " Order received in court on [specify date(s) and to whom given]: Services and assistance ordered under F.C.A. §1015-a must be authorized under the comprehensive annual services program plan in effect. American LegalNet, Inc. www.FormsWorkFlow.com 1