F.C.A.§§ 756, 771, 772 Form 7-12 (Person in Need of Supervision--Order on Petition for Discontinuance of Treatment) 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 Docket No. A Person Alleged to be a Person In Need of Supervision, Respondent. ________________________________ ORDER (Discontinuance of Treatment) A petition having been filed herein by alleging that it (has discontinued or suspended its work) (is unwilling to care for the above-named respondent for the reason that (support by) (the State of New York) (one of the State of New York's political subdivisions) has been discontinued) (it has fundamentally altered its program and as a result respondent can no longer benefit therefrom) and requesting the return of the above-named Respondent to this Court for disposition pursuant to section 772 of the Family Court Act; and The matter having duly come on before this Court and it appearing that the allegations of the petition have (not) been established; NOW therefore, it is hereby ORDERED, that the (relief sought herein is denied and the petition is hereby dismissed) (petition is hereby granted); (and it is further) (ORDERED ). American LegalNet, Inc. www.FormsWorkFlow.com Form 7-12 Page 2 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. ENTER Dated: , . _____________________________________ Judge of the Family Court. 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