F.C.A.§§ 418; 532 Art.5-B Form 5-6 (Order for Genetic Marker Test) 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/Support Magistrate _____________________________________ In the Matter of a Paternity Proceeding Docket No. (Commissioner of Social Services, Assignee, on behalf of , Assignor) ORDER FOR GENETIC MARKER TEST Petitioner, S.S.#: xxxx-xx-againstRespondent S.S.#: xxxx-xx______________________________________ The above-named (Petitioner) (Respondent) having moved this Court for an order requiring the mother, the child and the alleged father to submit to one or more genetic marker tests by a (duly qualified physician) (public health officer) pursuant to section (418) (532)(Art.5-b) of the Family Court Act, to determine whether the alleged father is the father of the child, [specify name and social security number:] it is hereby ORDERED that the following appear before the designated provider with proper picture identification and this order for the purpose of submitting to such genetic marker test or tests: Name Provider Date Time ORDERED that the custodial party shall bring the child(ren) required for testing; ORDERED that said mother, child and alleged father appear at [specify address]: on [specify date:] purpose of submitting to such genetic marker test or tests; and it is further for the [Check box if applicable]: G ORDERED that the [specify entity obtaining specimens]: American LegalNet, Inc. www.FormsWorkFlow.com Form 5-6 Page 2 shall forward the specimens of the mother, child and alleged father to [specify]: ; and it is further ORDERED that upon completion of said test, shall mail a copy of the report thereon to the (attorneys for the) Petitioner and Respondent, respectively, and file the original in the office of the Clerk of this Court; and it is further ORDERED that the test shall be paid for by check or money order by [check applicable box]: “ Respondent “ Petitioner; and it is further . ORDERED that the report of said test(s), if certified in accordance with Section 4518(d) of the Civil Practice Law and Rules; is admissible in evidence unless objections to the report are made in writing to the Clerk of the Court no later than twenty days before the hearing or thirty days after receipt of the report of the test results, whichever is earlier, and if no such timely objections are made, they are deemed waived. The next court date is [specify] IF THIS ORDER IS ENTERED BY A JUDGE, 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, OR 30 DAYS AFTER SERVICE BY A PARTY OR THE ATTORNEY FOR THE CHILD UPON THE APPELLANT, OR 35 DAYS FROM THE DATE OF MAILING OF THE ORDER TO APPELLANT BY THE CLERK OF COURT, WHICHEVER IS EARLIEST. IF THIS ORDER WAS ENTERED BY A SUPPORT MAGISTRATE, SPECIFIC WRITTEN OBJECTIONS TO THIS ORDER MAY BE FILED WITH THIS COURT WITHIN 30 DAYS OF THE DATE THE ORDER WAS RECEIVED IN COURT OR BY PERSONAL SERVICE, OR IF THE ORDER WAS RECEIVED BY MAIL, WITHIN 35 DAYS OF THE MAILING OF THE ORDER. ENTER ____________________________________ Judge of the Family Court/Support Magistrate Dated: ,. 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]:_____________________ American LegalNet, Inc. www.FormsWorkFlow.com