F.C.A. §§ 433, 453, 454, ART.5-B; C.P.L.R § 5242 (TO BE USED W HEN PERSON BEING SUMMONED IS NOT A NEW YORK STATE RESIDENT) Form 4-12a-2 (Violation of Support OrderNon-Resident) 8/2010 FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF In the Matter of a Proceeding for Support under Article of the Family Court Act (Commissioner of Social Services, Assignee on behalf of , Assignor) Petitioner, SUMMONS (NON-RESIDENT) (Violation of Support Order) Docket No. -againstRespondent. IN THE NAME OF THE PEOPLE OF THE STATE OF NEW YORK TO THE ABOVENAMED RESPONDENT: who resides or is found at A petition having been filed alleging that you have failed to obey the support order dated , made by this Court under Article of the Family Court Act, a copy of the petition being annexed hereto; YOU ARE HEREBY SUMMONED to appear before this Court, located at , New York on , , at o'clock in the noon of that day to answer the petition and show cause why you should not be dealt with in accordance with Section 454 of the Family Court Act and Section 5242 of the Civil Practice Law and Rules. Dated: , . BY ORDER OF THE COURT Clerk of the Court NOTICE: YOUR FAILURE TO APPEAR OR TO TESTIFY BY TELEPHONE, AUDIOVISUAL MEANS OR OTHER ELECTRONIC MEANS MAY RESULT IN YOUR IMMEDIATE ARREST OR MAY RESULT IN SUSPENSION OF YOUR DRIVER'S American LegalNet, Inc. www.FormsWorkFlow.com Form 4-12a-2, Page 2 LICENSE, STATE-ISSUED PROFESSIONAL, OCCUPATIONAL AND BUSINESS LICENSES; AND RECREATIONAL AND SPORTING LICENSES AND PERMITS. YOU HAVE THE RIGHT TO BE REPRESENTED BY A LAWYER. IF YOU CANNOT AFFORD A PRIVATE LAWYER, YOU HAVE THE RIGHT TO ASK THE COURT TO ASSIGN A LAWYER. IF, AFTER HEARING, THE JUDGE FINDS THAT YOU WILLFULLY FAILED TO OBEY THE ORDER, YOU MAY BE IMPRISONED FOR A TERM NOT TO EXCEED SIX MONTHS FOR CONTEMPT OF COURT. NOTICE TO NON - NEW YORK STATE RESIDENTS: SECTION 580-316 OF THE FAMILY COURT ACT OF THE STATE OF NEW YORK PROVIDES THAT THE COURT MAY PERMIT A PARTY OR WITNESS RESIDING IN ANOTHER STATE1 TO BE DEPOSED OR TO TESTIFY BY TELEPHONE, AUDIO-VISUAL MEANS OR OTHER ELECTRONIC MEANS AT A DESIGNATED TRIBUNAL OR OTHER LOCATION IN THAT STATE. IF YOU ARE UNABLE TO APPEAR IN PERSON YOU MAY APPLY FOR PERMISSION TO TESTIFY BY TELEPHONE, AUDIO-VISUAL MEANS OR OTHER ELECTRONIC MEANS. IF YOU WISH TO REQUEST THIS PERMISSION YOU MUST RETURN THE ATTACHED "ELECTRONIC TESTIMONY APPLICATION" TO THIS COURT EITHER BY CERTIFIED MAIL OR TELEPHONE FACSIMILE (FAX No. : ) IN ORDER FOR IT TO BE RECEIVED BY THIS COURT NOT LATER THAN THREE DAYS, EXCLUDING SATURDAYS, SUNDAYS AND HOLIDAYS, IN ADVANCE OF THE HEARING DATE ON THIS SUMMONS. IF YOUR APPLICATION IS DENIED YOU WILL BE SO NOTIFIED. YOUR FAILURE TO APPEAR IN PERSON OR BY COURT-APPROVED ELECTRONIC TESTIMONY MAY RESULT IN A DEFAULT JUDGMENT BEING ENTERED AGAINST YOU. NOTICE: Family Court Act §154(c) provides that petitions brought pursuant to Articles 4, 5, 6, 8 and 10 of the Family Court Act, in which an order of protection is sought or in which a violation of an order of protection is alleged, may be served outside the State of New York upon a Respondent who is not a resident or domiciliary of the State of New York. If no other grounds for obtaining personal jurisdiction over the Respondent exist aside from the application of this provision, the exercise of personal jurisdiction over the Respondent is limited to the issue of the request for, or alleged violation of, the order of protection. Where the Respondent has been served with this summons and petition and does not appear, the Family Court may proceed to a hearing with respect to issuance or enforcement of the order of protection. FCA Section 580-101(19) defines "State" as a state of the United States, the District of Columbia, Puerto Rico, the United States Virgin Islands or any territory or insular possession subject to the jurisdiction of the United States. The term includes: (i) an Indian tribe; and (ii) a foreign jurisdiction that has enacted a law or established procedures for issuance and enforcement of support orders which are substantially similar to the procedures under this Article, the Uniform Reciprocal Enforcement of Support Act, or the Revised Uniform Reciprocal Enforcement of Support Act. 1 American LegalNet, Inc. www.FormsWorkFlow.com