Affidavit In Support Of Entry Of Out-Of-State Order Of Protection Onto Statewide Registry
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Affidavit In Support Of Entry Of Out-Of-State Order Of Protection Onto Statewide Registry Form. This is a New York form and can be use in Family Court Statewide.
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Tags: Affidavit In Support Of Entry Of Out-Of-State Order Of Protection Onto Statewide Registry, GF-5e, New York Statewide, Family Court
D.R.L. §§240(3-c), 252; F.C.A. §154-e;
C.P.L. §530.11(5)
Family Court General Form 5e
Criminal Form Crim- 4b
Supreme Court Form SC-4
Court
County of
---------------------------------------------------------------Index/Docket #
Petitioner
-against-
AFFIDAVIT IN SUPPORT OF
ENTRY OF OUT-OF-STATE ORDER OF
PROTECTION OR TEMPORARY ORDER OF
PROTECTION ONTO STATEWIDE
REGISTRY OF ORDERS OF PROTECTION
Respondent
---------------------------------------------------------------State of New York
County of
)
): ss:
)
I,__________________________________, the undersigned affiant, having been duly sworn,
depose and state the following under the penalties of perjury:
1. I am a person, born on [specify date of birth]:
, and was named in the
annexed order that was issued by the [specify court]:
,
located at [specify county, state or territory and, if possible, address]:
on [specify date]:
. This order was entered in a proceeding entitled [specify]:
2. Upon information and belief, this order is valid as written at the present time and has not
been modified or vacated by any court. It expires on [specify date or duration]:
.
For the reasons stated above, I am requesting that the annexed order be entered without fee onto
the New York State Registry of Orders of Protection.
Sworn to before me
this day of
__________________
Notary
_________________________________
AFFIANT
_________________________________
Print or Type Name
__________________________________
(Optional): Attorney’s Name
_________________________________
Attorney’s Address
_________________________________
_________________________________
Attorney’s Telephone
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