F.C.A. § 524, 531-a, Art 5-B (To Be Used for Service Within New York State) Form 5-1-a (Summons - Paternity) (Service Within NYS) 8/2010 FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF ___________________________ ...................................................................................... In the Matter of a Proceeding under Article __ of the Family Court Act (Commissioner of Social Services, Assignee on behalf of , Assignor Petitioner, Docket No._________ SUMMONS-PATERNITY (Service Within NYS) -againstRespondent, ....................................................................................... NOTICE: YOUR FAILURE TO APPEAR SHALL RESULT IN AN ENTRY OF AN ORDER OF FILIATION ON DEFAULT UPON PROOF THAT YOU RECEIVED ACTUAL NOTICE OF THE COMMENCEMENT OF THIS PROCEEDING. YOUR FAILURE TO APPEAR MAY ALSO RESULT IN A WARRANT FOR YOUR ARREST AND SUSPENSION OF YOUR DRIVING PRIVILEGES; STATE-ISSUED PROFESSIONAL, OCCUPATIONAL AND BUSINESS LICENSES; AND RECREATIONAL AND SPORTING LICENSES AND PERMITS.1 IN THE NAME OF THE PEOPLE OF THE STATE OF NEW YORK TO THE ABOVENAMED RESPONDENT , who resides or is found at: ___________________________________________________________________ __________________________________________________________________________________ _____________ (A Petition)(Petitions) under Article __ of the Family Court Act having been filed with this Court and annexed hereto YOU ARE HEREBY SUMMONED to appear before this court at _______________ ______________________________________________, New York, on , , at o'clock in the noon of that day to show cause why the declaration of paternity, order of filiation, order of support and other and further relief requested in the petition should not be made. 1 Pursuant to Section 531-a of the Family Court Act, you may qualify to testify by telephone, audio-visual means or other electronic means if you reside in a county in New York State not contiguous to the Family Court in which the matter will be heard, if you are incarcerated and do not expect to be released within a reasonable period of time after the scheduled date or if you will suffer an undue hardship by appearing in court. The five counties of New York City are treated as one county for purposes of this section. If you wish to request permission, you must submit Form 4-24/5-16/UIFSA-10, which you may obtain from Family Court or on the internet at www.courts.state.ny.us. American LegalNet, Inc. www.FormsWorkFlow.com Form 5-1a Page 2 Dated: , . _______________________________ Clerk of the Court NOTICE: Family Court Act §154(c) provides that support, paternity, custody, family offense and child abuse and neglect petitions, in which an order of protection is sought or in which a violation of an order of protection is alleged, may be served outside the State of New York upon a Respondent who is not a resident or domiciliary of the State of New York. In such instance, the exercise of personal jurisdiction over the Respondent is limited to the issue of the request for, or alleged violation of, the order of protection, unless the Uniform Interstate Family Support Act or Family Court Act §154(b) provides other grounds for the exercise of personal jurisdiction over the Respondent. Where the Respondent has been served with this summons and petition and does not appear, the Family Court may proceed to a hearing with respect to issuance or enforcement of the order of protection. FINANCIAL DISCLOSURE NOTICE IF THE COURT ENTERS AN ORDER OF PATERNITY (ORDER OF FILIATION), THE COURT WILL IMMEDIATELY PROCEED TO ENTER AN ORDER OF SUPPORT. IN THE SUPPORT PROCEEDING, YOU ARE REQUIRED TO PROVIDE THE COURT WITH A CURRENT AND REPRESENTATIVE PAYCHECK STUB AND MOST RECENTLY FILED STATE AND FEDERAL INCOME TAX RETURNS, INCLUDING A COPY OF THE W-2 WAGE AND TAX STATEMENT(S) SUBMITTED WITH THE RETURN. YOU MAY BE REQUIRED TO FURNISH PAST INCOME TAX RETURNS; EMPLOYER STATEMENTS; PAY STUBS; CORPORATE, BUSINESS OR PARTNERSHIP BOOKS AND RECORDS; CORPORATE AND BUSINESS TAX RETURNS; AND RECEIPTS FOR EXPENSES OR SUCH OTHER MEASURES OF VERIFICATION AS THE COURT DETERMINES APPROPRIATE. IF YOU WILL BE CONSENTING TO ENTRY OF THE DECLARATION OF PATERNITY REQUESTED IN THE PETITION ON THE RETURN DATE OF THIS SUMMONS YOU SHOULD BRING THE ABOVE DOCUMENTS WITH YOU TO COURT ON THAT DAY. American LegalNet, Inc. www.FormsWorkFlow.com