Affidavit In Support Of Entry Out Of State Order Of Protection Or Temporary Order Of Protection Onto Satewide Registry
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Affidavit In Support Of Entry Out Of State Order Of Protection Or Temporary Order Of Protection Onto Satewide 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 Out Of State Order Of Protection Or Temporary Order Of Protection Onto Satewide Registry, GF-5d, 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 5d
Criminal Form Crim- 4a
Supreme Court Form SC-3
FAMILY COURT
COUNTY OF
_____________________________
Petitioner
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
Docket #
_______________________________
State of New York)
) ss:
County of
)
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.
__________________________
AFFIANT
Print or Type Name
Sworn to before me
day of
this
Attorney Name, Address and Telephone
(Optional):
NOTARY PUBLIC
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