Secs. 773 F.C.A. Form 7-13 (Person in Need of Supervision) 7/83 FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF In the Matter of A Person Alleged to be a Person in Need of Supervision, Respondent. TO THE FAMILY COURT: Docket No. PETITION (Transfer for Incorrigibility) The undersigned Petitioner respectfully alleges that: l. Petitioner, , is an agency, society, or institution other than a state training school duly authorized to accept the placement of persons under Article 7 of the Family Court Act. 2. Under an Order of Fact-finding and Disposition of this Court. dated . the above-named Respondent was adjudicated to be a person in need of supervision within the meaning of Article 7 of the Family Court Act. and was placed with Petitioner pursuant to section 756 of the Family Court Act 1 3. (Respondent is incorrigible and (his) (her) presence is seriously detrimental to the welfare of Petitioner or of other persons in its rare in that [specify the acts of the Respondent]: ''-4. (After placement by this Court, Respondent was released on (parole) (probation) from Petitioner upon the following terms and condition(s): and Respondent willfully violated the terms and condition(s) in that Respondent [specify acts constituting violation]: 5. No previous application has been made to any court or judge for the relief herein requested (except WHEREFORE, Petitioner prays that Respondent be transferred from Petitioner and placed with a society or agency, governed or controlled by persons of the same religious faith or persuasion as that of Respondent. or, if such transfer is not practicable, to some other suitable institution. Dated: , ____, Petitioner By: )Delete if inapplicable. 2 Delete if inapplicable. American LegalNet, Inc. www.USCourtForms.com VERIFICATION (Agency) STATE OF NEW YORK COUNTY OF ) ss.: being duly sworn, deposes and says: That (s)he is the of , an agency authorized to originate the above-entitled proceeding, and is acquainted with the facts and circumstances therein; that (s)he has read the foregoing and knows the contents thereof; that the same 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. Name Title Sworn to before me this day of . ____, Notary Public American LegalNet, Inc. www.USCourtForms.com