F.C.A. §§ 617; CPLR 315, 316

General Form 30 (SummonsPublication) 12/97

FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF ________________________ .......................................................................................... In the Matter of a Proceeding under Article _____ of the Family Court Act

Docket No.

SUMMONS (Publication) Respondent .........................................................................................
IN THE NAME OF THE PEOPLE OF THE STATE OF NEW YORK TO THE ABOVE-NAMED RESPONDENT: ____________________________________________________________________________, WHO RESIDES OR IS FOUND AT: ____________________________________________________________ and to _____________________________________________________________________________________ address(es)__________________________________________________________________________________ the (state relationship)_________________________________________________________ (A)(P)petition(s) under Article _____ of the Family Court Act having been filed with this Court requesting [Indicate the nature of relief requested]: ____________________________________________________________ ____________________________________________________________________________________________. YOU AND EACH OF YOU ARE HEREBY SUMMONED to appear before this Court at __________, New York, on _______________________, 19___, at ____ o'clock in the ____ noon, of that day to answer the petition and to be dealt with in accordance with Article _____ of the Family Court Act. On your failure to appear as herein directed, a warrant may be issued for your arrest. [Termination of Parental Cases only]: Upon your failure to appear, all of your parental rights may be terminated and your failure to appear shall further constitute a denial of your interest in the child(ren) who are the subject of the proceeding, which denial may result, without further notice, in the transfer or commitment of the child('s)(ren's) care, custody or guardianship or in the child('s)(ren's) adoption in this or any subsequent proceeding in which such care, custody or guardianship or adoption may be at issue.

Dated:______________________, 19___.

____________________________________ Clerk of Court

TO THE ABOVE-NAMED RESPONDENT(S): The foregoing summons is served upon you by publication pursuant to an Order of the Hon. __________________________, Judge of the Family Court, __________________________________ County, dated and filed with the petition and other papers in the Office of the Clerk of the Family Court, ________________________ County.