Free F.C.A. §§ 812, 818, 821 Form 8-2 (Family Offense Petition) (9/2008) FAMILY C... - New York

F.C.A. §§ 812, 818, 821

Form 8-2 (Family Offense Petition) (9/2008)

FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF .......................................................................................... Petitioner -againstDocket No. FAMILY OFFENSE PETITION

Respondent ............................................................................................ TO THE FAMILY COURT: The undersigned Petitioner respectfully states that: 1. a. I reside at [specify address unless confidential]:1 b. The Respondent resides at [specify]: 2. a. The Respondent and I are related as follows [check applicable box(es)]: we are married we were married we have a child in common we are parent & child we are related by blood or marriage [specify how]: we are in an intimate relationship (NOT casual social or business acquaintances) [describe]: we were in an intimate relationship (NOT casual social or business acquaintances) [describe]: b. I am a peace officer. 3. The Respondent committed the following family offense(s) against me and/or my children, which constitute attempted assault assault aggravated harassment harassment disorderly conduct menacing reckless endangerment stalking criminal mischief other [specify]: [Describe incident, state date, time and place of most recent incident, specify if anyone was injured (how seriously) and if any weapons were used. If there were earlier incidents as well, describe them in additional paragraphs. Use additional sheets where necessary]:

4. I have have not filed a criminal complaint concerning these incident(s) [If so, please indicate status].
If your health or safety or that of your child or children would be put at risk by disclosure of your address or other identifying inform ation, you m ay apply to the Court for an address confidentiality order by subm itting General Form GF-21, which is available on-line at www.nycourts.gov. See Fam ily Court Act §154-b.
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Form 8-2

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5. [Check applicable box(es)]: a. I have no children and there are no other children living in my home. b. The following children live with me (include children who are not yours). Date of Birth Relationship to Me Relationship to Respondent

Name

Name

c. The following children are mine but do not live with me. Date of Birth Lives With Child's Relationship to Respondent

e. The Respondent committed family offenses against the above child or children as follows [describe including name(s) of child or children, nature of offense(s) and date(s)]:2

[Check boxes and complete any of the following paragraphs 6-13 that apply to you. Skip any that do not apply to you.] 6. The Respondent has acted in a way I consider dangerous or threatening to me, my children or any member of my family, in addition to the incident described in question 3, as follows [describe]: 7. The Respondent was found to have violated an Order of Protection issued on behalf of me or members of my family or household as follows [describe]: . 8. The Respondent owns or has access to guns as follows [describe]: 9. a. The Respondent has a gun license or pistol permit for the following gun(s) as follows [describe]:

b. The Respondent has a gun license or permit application pending as follows [describe]: c. The Respondent carries a gun on his or her job as follows [describe]:

Fam ily offenses include the crim es of assault or attem pted assault, aggravated harassm ent or harassm ent, disorderly conduct, m enacing, reckless endangerm ent, stalking or crim inal m ischief.

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10. a. The Respondent threatened me my child or children [specify]: a member or members of my household [specify]: with a gun or dangerous instrument or object as follows [specify]:

b. There is a substantial risk that Respondent would use or threaten to use a firearm or dangerous instrument or object against me, my child(ren) or member of my household on the basis of the following facts and for the following reasons [describe]: 11. The following court cases are pending between me and the Respondent [specify court, docket or index number, nature of action and status, if known]:

12. The Respondent has the following criminal convictions [specify, including date, crime, sentence and court, if known]: 13. [Applicable where protection is sought for pet(s)]: a. The following pets live in my house [specify name(s) and type(s)]: b. The Respondent injured or tried or threatened to injure pets in my household as follows [describe]:

14. I have not made any previous application to any court or judge for the relief requested in this petition, (except [specify the relief, if any, granted and the date of such relief; delete if inapplicable]: ). WHEREFORE, Petitioner respectfully requests this Court to: a. adjudge the Respondent to have committed the family offense(s) alleged; b. enter an order of protection, specifying conditions of behavior to be observed by the Respondent in accordance with Section 842 of the Family Court Act; c. enter a finding of aggravated circumstances [delete if inapplicable]; d. enter a temporary order of child support in accordance with Family Court Act §828(4) [delete if inapplicable]; e. order such other and further relief as to the Court seems just and proper. Dated:
__________________________________

Petitioner: (print or type name)

/

Signature

Petitioner's Attorney, if any (print or type name) /

Signature

Form 8-2

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Address and telephone number of Attorney, if any

VERIFICATION STATE OF NEW YORK COUNTY OF ) :ss.: )

being duly sworn, says that (he)(she) is the Petitioner(s) in the above-named proceeding and that the foregoing petition is true to (his)(her) own knowledge, except as to matters stated to be alleged on information and belief and as to those matters (he)(she) believe(s) them to be true.

___________________________/________________________ Petitioner: type or print name / Signature Sworn to before me this day of , . __________________________ (Deputy)Clerk of the Court Notary Public