Form 5-1 "Petition for Paternity (Individual)" - Nassau County, New York

What Is Form 5-1?

This is a legal form that was released by the Family Court of the State of New York - a government authority operating within New York. The form may be used strictly within Nassau County. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2015;
  • The latest edition provided by the Family Court of the State of New York;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form 5-1 by clicking the link below or browse more documents and templates provided by the Family Court of the State of New York.

ADVERTISEMENT
ADVERTISEMENT

Download Form 5-1 "Petition for Paternity (Individual)" - Nassau County, New York

1307 times
Rate (4.7 / 5) 65 votes
Page 1 of 5
F.C.A. § § 522, 523, S.S.L. § 111-g
Form 5-1
[Note: Nassau County Family Court (NCFC) Information
Paternity
Sheets containing the Social Security #’s of the parties
10/2012
and the dependents must be filed with this petition]
NCFC 4/2015
FAMILY COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
.........................................................................................
In the Matter of a Paternity Proceeding
PETITION for Paternity
(Individual)
Petitioner
FILE #
First
M.I.
Last
DOCKET #
-AGAINST-
(Court use only)
Respondent
First
M.I.
Last
.........................................................................................
TO THE FAMILY COURT:
The undersigned petitioner respectfully alleges that:
1.
Check one box only:
G
I am the petitioner and I am the birth mother of the child who is the subject of this petition.
I am submitting this petition to request an order declaring the respondent to be the father
of the child.
G
I am the petitioner and I am pregnant with the child who is the subject of this petition. I am
submitting this petition to request an order declaring the respondent to be the father of the
child.
G
I am the petitioner and I am the father of the child who is the subject of this petition. I am
submitting this petition to request an order declaring me to be the father of the child.
G
I am the petitioner and I may be the father of the child who is the subject of this petition.
I am submitting this petition to request an order determining the paternity of the child.
2a.
Petitioner’s Information:
2b.
Respondent’s Information:
Name:
Name:
Date of Birth:
Date of Birth:
*Address:
Address:
* If address is not known to the respondent and you are requesting that your address be kept
confidential from the respondent, print the word CONFIDENTIAL above and print your address
on the NCFC Information Sheet only.
Page 1 of 5
F.C.A. § § 522, 523, S.S.L. § 111-g
Form 5-1
[Note: Nassau County Family Court (NCFC) Information
Paternity
Sheets containing the Social Security #’s of the parties
10/2012
and the dependents must be filed with this petition]
NCFC 4/2015
FAMILY COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
.........................................................................................
In the Matter of a Paternity Proceeding
PETITION for Paternity
(Individual)
Petitioner
FILE #
First
M.I.
Last
DOCKET #
-AGAINST-
(Court use only)
Respondent
First
M.I.
Last
.........................................................................................
TO THE FAMILY COURT:
The undersigned petitioner respectfully alleges that:
1.
Check one box only:
G
I am the petitioner and I am the birth mother of the child who is the subject of this petition.
I am submitting this petition to request an order declaring the respondent to be the father
of the child.
G
I am the petitioner and I am pregnant with the child who is the subject of this petition. I am
submitting this petition to request an order declaring the respondent to be the father of the
child.
G
I am the petitioner and I am the father of the child who is the subject of this petition. I am
submitting this petition to request an order declaring me to be the father of the child.
G
I am the petitioner and I may be the father of the child who is the subject of this petition.
I am submitting this petition to request an order determining the paternity of the child.
2a.
Petitioner’s Information:
2b.
Respondent’s Information:
Name:
Name:
Date of Birth:
Date of Birth:
*Address:
Address:
* If address is not known to the respondent and you are requesting that your address be kept
confidential from the respondent, print the word CONFIDENTIAL above and print your address
on the NCFC Information Sheet only.
Page 2 of 5
3.
The petitioner had sexual intercourse with the above-named respondent during a period of time
beginning on or about
and ending on or about
.
a. The G petitioner G respondent gave birth to a G male G female child out of wedlock
4.
on [specify date]
.
or
b. The G petitioner G respondent is now pregnant with a child who is likely to be born out
of wedlock.
I am the petitioner and G I am G I am not requesting an order for genetic testing to determine
5.
the paternity of the child.
6.
At the time the child was conceived, the mother:
G was not married (child born out of wedlock),
or
G was married to:
Name:
*Address:
* If address is not known to the respondent and you are requesting that the address be kept
confidential from the respondent, print the word CONFIDENTIAL above and print the spouses’s
address on another NCFC Information Sheet only.
7.
The name of the person who is or may be the father of the child is
.
[check
applicable box(es)]:
a. G He has acknowledged paternity in writing.
b. G He has acknowledged paternity by furnishing support.
c. G He is the petitioner and acknowledges paternity by the filing of this petition.
d. G none of the above.
8.
The child’s information, specify: Name:
Date of Birth:
G Male
G Female
Sex:
G The birth certificate is attached [it must be attached if the petitioner is the mother].
or
G The birth certificate is unavailable, because
.
Page 3 of 5
9a.
Has any other person been named the father of this child by this court or any other court,
including a Native American court?
G Yes
G No
If yes, specify:
Name of Court (include county & state):
Docket #:
Names on the Case:
.
9b.
Has any other person signed an acknowledgment of paternity for this child?
G Yes,
has signed an acknowledgment of paternity.
G No
10.
Has there been an application made in any court for the relief herein requested?
G Yes
G No
If yes, specify:
Name of Court (include county & state):
Docket #:
Names on the Case:
.
11.
Does the child live with you?
G Yes
G No
If yes, check
one box below.
G I have already made an application for child support enforcement services with the Nassau
County Department of Social Services Support Collection Unit (SCU); I request that the order of
support be payable through the New York State Office of Child Support Enforcement (OCSE).
G By filing this petition, I am now making an application for child support enforcement services
with SCU. I request that the order of support be payable through OCSE. I understand that I must
file additional documentation directly with SCU.
G I do not wish to make application for child support services with SCU. I request that the order
of support be payable directly to me without involvement from SCU or OCSE or I may not request
an order of child support at this time.
12.
Is the child a Native American child subject to the Indian Child Welfare Act of 1978 (25 U.S.C.
G Yes
G No
§ § 1901-1963)?
Page 4 of 5
Pursuant to F.C.A. § 545, upon the entry of an order of filiation, the court shall, upon application of either
party, enter an order of support for the subject child.
WHEREFORE, the petitioner requests that this court issue a summons or warrant requiring the
respondent to show cause why the court should not enter a declaration of paternity, an order of
support and such other and further relief as may be appropriate under the circumstances.
NOTE: (1) A COURT ORDER OF SUPPORT RESULTING FROM A PROCEEDING COMMENCED BY
THIS APPLICATION (PETITION) SHALL BE ADJUSTED BY THE APPLICATION OF A COST
OF LIVING ADJUSTMENT AT THE DIRECTION OF THE SUPPORT COLLECTION UNIT NO
EARLIER THAN TWENTY-FOUR MONTHS AFTER SUCH ORDER IS ISSUED, LAST
MODIFIED OR LAST ADJUSTED, UPON THE REQUEST OF ANY PARTY TO THE ORDER OR
PURSUANT TO PARAGRAPH (2) BELOW. SUCH COST OF LIVING ADJUSTMENT SHALL BE
ON NOTICE TO BOTH PARTIES WHO, IF THEY OBJECT TO THE COST OF LIVING
ADJUSTMENT, SHALL HAVE THE RIGHT TO BE HEARD BY THE COURT AND TO PRESENT
EVIDENCE WHICH THE COURT WILL CONSIDER IN ADJUSTING THE CHILD SUPPORT
ORDER IN ACCORDANCE WITH SECTION FOUR HUNDRED THIRTEEN OF THE FAMILY
COURT ACT, KNOWN AS THE CHILD SUPPORT STANDARDS ACT.
(2) A PARTY SEEKING SUPPORT FOR ANY CHILD(REN) RECEIVING FAMILY ASSISTANCE
SHALL HAVE A CHILD SUPPORT ORDER REVIEWED AND ADJUSTED AT THE DIRECTION
OF THE SUPPORT COLLECTION UNIT NO EARLIER THAN TWENTY-FOUR MONTHS AFTER
SUCH ORDER IS ISSUED, LAST MODIFIED OR LAST ADJUSTED BY THE SUPPORT
COLLECTION UNIT, WITHOUT FURTHER APPLICATION BY ANY PARTY. ALL PARTIES
WILL RECEIVE A COPY OF THE ADJUSTED ORDER.
(3) WHERE ANY PARTY FAILS TO PROVIDE, AND UPDATE UPON ANY CHANGE, THE
SUPPORT COLLECTION UNIT WITH A CURRENT ADDRESS, AS REQUIRED BY SECTION
FOUR HUNDRED FORTY-THREE OF THE FAMILY COURT ACT, TO WHICH AN ADJUSTED
ORDER CAN BE SENT, THE SUPPORT OBLIGATION AMOUNT CONTAINED THEREIN SHALL
BECOME DUE AND OWING ON THE DATE THE FIRST PAYMENT IS DUE UNDER THE
TERMS OF THE ORDER OF SUPPORT WHICH WAS REVIEWED AND ADJUSTED
OCCURRING ON OR AFTER THE EFFECTIVE DATE OF THE ADJUSTED ORDER,
REGARDLESS OF WHETHER OR NOT THE PARTY HAS RECEIVED A COPY OF THE
ADJUSTED ORDER.
Dated:
Petitioner [sign name]
Petitioner [print name]
Page 5 of 5
VERIFICATION
STATE OF
)
:ss.:
COUNTY OF
)
being duly sworn, says that (s)he is the petitioner in the above-named proceeding and that the foregoing
petition 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.
Petitioner [sign name before a notary]
Sworn to before me this
day of
, 20
Notary Public