F.C.A.247247 430, 446, 453 - 460, 550, 551, 655, 656, General Form 8 828, 842, 842 - a, 846, 846 - a, 1029, (Petition - Violation of 1056, 1072 Order of Protection) 3/2018 FAMILY COURT OF THE STATE OF NEW YORK COUN TY OF ...................................................................................... In the Matter of a Proceeding under Article of the Family Court Act Docket No. Petitioner, - against - PETITION (Violation of Order of Protection) Respondent. ...................................................................................... WARNING : THE PURPOSE OF THE HEARING REQUESTED IN THIS PETIT ION IS TO PUNISH [Specify name] FOR CONTEMPT OF COURT, WHICH MAY INCLUDE SANCTIONS OF A FINE OR IMPR ISONMENT OR BOTH. YOUR FAILURE TO APPEAR IN COURT MAY R ESULT IN YOUR IMMEDIATE ARREST AND IMPRISONMENT FOR CONTEMPT OF COURT. TO THE FAMILY COURT: The undersigned Petitioner Respondent respectfully shows that: 1. a. Petitioner, , [check applicable box]: resides is located at [specify address or indicate if ordered to be kept confidential pursuant to Family Court Act 247154 - b(2) or Domestic Relations Law 247254]: b. Respond ent, , [check applicable box]: resides is located at [specify address or indicate if ordered to be confidential, pursuant to Family Court Act 247154 - b(2) or Domestic Relations Law 247254]: 2. By Order of this Court , dated , , the Petitioner R espondent was directed to observe the following conditions of behavior: 3. (Upon information and belief) Petitioner Respondent has failed to obey the Ord er of this Court in that [specify, including date(s), description(s) and location(s)]: 4. The following child(ren) is/are the subject(s) of the proceeding resulting in the issuance of the Orde r alleged to have been violated : American LegalNet, Inc. www.FormsWorkFlow.com General Form 8 page 2 Name Date o f Birth Address 1 5. No previous application has been made to any court or judge for the relief herein requested (except [specify]: . WHEREFORE, Petitioner Respondent requests that the Petitioner Respondent be dealt with, in accordance with Section of the Family Court Act. Dated: . Signature of Petitioner Respondent Print or type name S ignature of Attorney, if any A VERIFICATION STATE OF NEW YORK) ):ss: COUNTY OF ) being duly sworn, says that (s)he is the Petitioner Respondent in the above named proceeding and that the foregoing petition is true to (his)(her) own knowledge, except as to matters therein stated to be alleged on information and belief and as to those matters (s)he believes it to be true. Petitioner Respondent Sworn to before me this day of . (Deputy) Clerk of the Court Notary Public 1 Unless the Court has ordered the address to be confidential on the ground that disclosure would pose an unreasonable health or safety risk. See Family Court Act247154 - b; Form 21, 21a (on - line at www.nycourts.gov). . American LegalNet, Inc. www.FormsWorkFlow.com