FCA 1035 , 1055                                                                                                                                               Form 10-7C
(Summons Child Neglect Proceeding)
92003                    
FAMILY COURT OF THE STATE OF NEW YORK
COUNTY OF QUEENS    
                                                                                            Docket No.: NN-99999/07

                      
SUMMONS CHILD NEGLECT CASE
----------------------------------------------------------------------x
In the Matter of

JOHN DOE
a Proceeding under Article 10 of the Family Court Act

JANE DOE,
Respondent
----------------------------------------------------------------------x
IN THE NAME OF THE PEOPLE OF THE STATE OF NEW YORK

NOTICE: PLACEMENT OF YOUR CHILD IN FOSTER CARE MAY RESULT IN LOSS OF YOUR RIGHTS TO YOUR CHILD. IF YOUR CHILD
STAYS
IN FOSTER CARE FOR 15 OF THE MOST RECENT 22 MONTHS, THE AGENCY MAY BE REQUIRED BY LAW TO FILE A PETITION TO
TERMINATE YOUR PARENTAL RIGHTS AND TO COMMIT GUARDIANSHIP AND CUSTODY OF YOUR CHILD TO THE AGENCY FOR THE  
PURPOSES OF ADOPTION . ALSO THE AGENCY MAY FILE BEFORE THE END OF THE 15-MONTH PERIOD IF SEVERE OR REPEATED CHILD
ABUSE IS PROVEN BY CLEAR AND CONVINCING EVIDENCE. THIS FINDING MAY CONSTITUTE THE BASIS FOR TERMINATING YOUR
PARENTAL RIGHTS AND TO COMMIT GUARDIANSHIP AND CUSTODY OF YOUR CHILD TO THE AGENCY FOR THE PURPOSES OF
ADOPTION.

TO: MRS .JANE DOE

A Petition under Article 10 of the Family Court Act having been filed with this court, and annexed hereto.

YOU ARE HEREBY SUMMONED to appear before this Court at:
151-20 Jamaica Avenue
Jamaica, NY 11432
Part 1
On September 24, 2007, at 4:00 o'clock in the afternoon of that day to answer the petition and to be dealt with in accordance with Article 10 of the Family Court
Act.
ON YOUR FAILURE TO APPEAR AS HEREIN DIRECTED, A WARRANT MAY BE ISSUED FOR YOUR ARREST.

BY ORDER OF THE COURT
HON. JOHNNIE DOE,
JUDGE OF THE FAMILY COURT
DATED JULY 25, 07

FURTHER NOTICE: Family Court Act 154 (c) provides that petition brought pursuant to Articles 4, 5, 6, 8 and 10 of the Family Court Act, in which an order
of protection is sought or in which a violation of an order of protection is alleged, may be served outside of the State of New York upon  a Respondent who is
not resident or domiciliary of the State of New York. If no other grounds for obtaining personal jurisdiction over the Respondent exist aside from the application
of this provision, 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.
When
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 the issuance
or enforcement of the order of protection.

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