F.C.A. §§ 841(a) Form 8-7 (Family Offense Order of Dismissal) (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 , . PRESENT: Hon. Judge ............................................................... Petitioner, -against- Docket No. ORDER OF DISMISSAL Respondent. ............................................................... A petition under Article 8 of the Family Court Act having been filed in this Court; and the Petitioner [specify]: having [check applicable box(es)]: appeared with counsel without counsel not appeared ; not appeared but counsel appeared; and the Respondent [specify]: having [check applicable box(es)]: appeared with counsel without counsel waived counsel not appeared ; not appeared after service not appeared but service could not be made after every reasonable effort had been made to effect service not appeared but counsel appeared; And the Court finds that after [check applicable box(es)]: examining the family offense and relationship allegations in the petition hearing the proofs and testimony offered in relation to the case It is hereby ordered that the petition is DISMISSED for the following reason(s) [check applicable box(es)]: the Petitioner withdrew the petition; American LegalNet, Inc. www.FormsWorkFlow.com Form 8-7 Page 2 want of prosecution; the allegations do not constitute a family offense; insufficient evidence of a family offense; lack of a relationship required by Family Court Act §812(1); other [specify]: And it is further ORDERED that this dismissal is [check applicable box]: with prejudice without prejudice. And it is further ORDERED that [specify]: Dated: , . ENTER ___________________________ Judge of the Family Court 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]:_____________________ 9 Order served by police on [specify date]:_______________________________________ American LegalNet, Inc. www.FormsWorkFlow.com