F.C.A.§§433, 531-a, 580-316 . At a term of the Family Court of the State of New York, held in and for the County of , at New York, on , Form 4-24a/5-16a/UIFSA-10a (Support, Paternity, UIFSA--Order on Electronic Testimony Application) (8/2010) PRESENT: Hon. FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF ......................................................................................... In the Matter of a Proceeding for Support or Paternity Under Article 4, 5 or 5-B of the Family Court Act Petitioner, Docket No. ________________ ORDER -Electronic Testimony Application -againstRespondent. .......................................................................................... The request of [specify name of applicant]: , dated [specify]: to testify or be deposed by telephone or other electronic means having been considered by this Court, it is hereby ORDERED that the request is: 9 GRANTED and the applicant must follow the instructions below. OR 9 DENIED for the following reasons: If this application is denied, the applicant must appear at the hearing in person. The hearing is scheduled for [specify date and time]: ENTER: DATED: QJudge of the Family Court QSupport Magistrate INSTRUCTIONS IF REQUEST FOR TELEPHONE OR ELECTRONIC TESTIMONY IS GRANTED: On [specify hearing or deposition date]: at 9 A.M. 9 P.M. , you must [check applicable box]: 9 call Part at telephone # OR 9 be available to receive a call from the Court; In order to confirm this arrangement for your testimony, you must call the following telephone number [specify]: at this Court no later than [specify deadline in advance of the hearing]:____________________________________ It is your responsibility to transmit the following documents to this Court, Part __, by fax [specify fax #]: or by personal delivery at least [check applicable box]: G___ hours G___ days prior to the hearing: 1) legible copies of your entire last- filed state and federal tax returns 2) proof of all income received in this year 3) a notarized Financial Disclosure form [Form 4-17, available on-line at www.nycourts.gov] , and 4) all other documents you intend to offer into evidence at the hearing. You may choose to appear in person in this Court on your trial date, rather than appear by telephone or other electronic means. You may retain an attorney to represent you in this Court while you appear by telephone or other electronic means. If you fail to appear, either in person or by telephone or other electronic means approved by this Court, this Court may hear the matter in your absence or may issue a WARRANT for your arrest. If you are the Petitioner, if you fail to appear, either in person, by telephone or other electronic means approved by this Court, the Court may DISMISS the petition. 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 IF THIS ORDER IS ENTERED BY A JUDGE, 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, 30 DAYS AFTER SERVICE BY A PARTY OR THE ATTORNEY FOR THE CHILD UPON THE APPELLANT, OR 35 DAYS FROM THE DATE OF MAILING OF THE ORDER TO APPELLANT BY THE CLERK OF COURT, WHICHEVER IS EARLIEST. IF THIS ORDER IS ENTERED BY A SUPPORT MAGISTRATE, SPECIFIC WRITTEN OBJECTIONS TO THIS ORDER MAY BE FILED WITH THIS COURT WITHIN 30 DAYS OF THE DATE THE ORDER WAS RECEIVED IN COURT OR BY PERSONAL SERVICE, OR IF THE ORDER WAS RECEIVED BY MAIL, WITHIN 35 DAYS OF THE MAILING OF THE ORDER. American LegalNet, Inc. www.FormsWorkFlow.com