F.C.A.§ 384-b Soc. Serv. Law 631 Form TPR-3 (Order Dismissing Petition Requesting Commitment of Guardianship and Custody) (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 , . P R E S E N T: Hon. Judge ____________________________________________ In the Matter of the Commitment of Guardianship and Custody pursuant to º 384-b of the Social Services Law of Docket No. ORDER DISMISSING PETITION CIN # A Child under the Age of Eighteen Years ____________________________________________ A petition under (Section 384-b of the Social Services Law) (Article 6, Part I of the Family Court Act) dated the day of , , having been filed in this Court alleging that _______________________________________________________________________________ _______________________________________________________________________________ and summons(s) having been duly issued and duly served upon [specify]: and notice having been duly given to all proper parties hereto; and the child having been represented by an attorney for the child, And the matter having duly come on for a hearing; and Respondent [specify]: having appeared with counsel without counsel waived counsel not appeared; Respondent [specify]: having appeared with counsel without counsel waived counsel not appeared; The Court, after hearing the proofs and the testimony offered in relation to the case finds and it is hereby American LegalNet, Inc. www.FormsWorkFlow.com Form TPR-3 page 2 ORDER AND ADJUDGED that the allegations of the petition herein have not been established as required by law; and it is therefore ORDERED that the petition is dismissed. ENTER _____________________________________ Judge of the Family Court Dated: , . 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: Order mailed on [specify date(s) and to whom mailed ]:___________________________ Order received in court on [specify date(s) and to whom given]:_____________________ American LegalNet, Inc. www.FormsWorkFlow.com