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| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB1698 Introduced , by Rep. Sara Feigenholtz SYNOPSIS AS INTRODUCED:
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750 ILCS 50/10 | from Ch. 40, par. 1512 |
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Amends the Adoption Act. Provides a form of waiver of parental rights to be used by a putative or legal father of a born or unborn child.
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| | A BILL FOR |
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1 | | AN ACT concerning civil law.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Adoption Act is amended by changing Section |
5 | | 10 as follows:
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6 | | (750 ILCS 50/10) (from Ch. 40, par. 1512)
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7 | | Sec. 10. Forms of consent and surrender; execution and
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8 | | acknowledgment thereof. |
9 | | A. The form of consent required for the
adoption of a born |
10 | | child shall be substantially as follows:
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11 | | FINAL AND IRREVOCABLE CONSENT TO ADOPTION
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12 | | I, ...., (relationship, e.g., mother, father, relative, |
13 | | guardian)
of ...., a ..male child, state:
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14 | | That such child was born on .... at ....
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15 | | That I reside at ...., County of .... and State of ....
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16 | | That I am of the age of .... years.
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17 | | That I hereby enter my appearance in this proceeding and |
18 | | waive
service of summons on me.
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19 | | That I hereby acknowledge that I have been provided with a |
20 | | copy of the Birth Parent Rights and Responsibilities-Private |
21 | | Form before signing this Consent and that I have had time to |
22 | | read, or have had read to me, this Form. I understand that if I |
23 | | do not receive any of the rights as described in this Form, it |
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1 | | shall not constitute a basis to revoke this Final and |
2 | | Irrevocable Consent. |
3 | | That I do hereby consent and agree to the adoption of such |
4 | | child.
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5 | | That I wish to and understand that by signing this consent |
6 | | I do
irrevocably and permanently give up all custody and other |
7 | | parental
rights I have to such child.
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8 | | That I understand such child will be placed for adoption |
9 | | and that I
cannot under any circumstances, after signing this |
10 | | document, change my
mind and revoke or cancel this consent or |
11 | | obtain or recover custody or
any other rights over such child. |
12 | | That I have read and understand the
above and I am signing it |
13 | | as my free and voluntary act.
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14 | | Dated (insert date).
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15 | | .........................
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16 | | If under Section 8 the consent of more than one person is |
17 | | required,
then each such person shall execute a separate |
18 | | consent.
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19 | | A-1. (1) The form of the Final and Irrevocable Consent to |
20 | | Adoption by a Specified Person or Persons: Non-DCFS Case set |
21 | | forth in this subsection A-1 is to be used by legal parents |
22 | | only. This form is not to be used in cases in which there is a |
23 | | pending petition under Section 2-13 of the Juvenile Court Act |
24 | | of 1987. |
25 | | (2) The form of the Final and Irrevocable Consent to |
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1 | | Adoption by a Specified Person or Persons in a non-DCFS case |
2 | | shall have the caption of the proceeding in which it is to be |
3 | | filed and shall be substantially as follows: |
4 | | FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY |
5 | | A SPECIFIED PERSON OR PERSONS; NON-DCFS CASE |
6 | | I, ...., (relationship, e.g., mother, father) of ...., a |
7 | | ..male child, state: |
8 | | 1. That such child was born on ...., at ....., City of ... |
9 | | and State of .... |
10 | | 2. That I reside at ...., County of .... and State of .... |
11 | | 3. That I am of the age of .... years. |
12 | | 4. That I hereby enter my appearance in this proceeding and |
13 | | waive service of summons on me. |
14 | | 5. That I hereby acknowledge that I have been provided a |
15 | | copy of the Birth Parent Rights and Responsibilities-Private |
16 | | Form before signing this Consent and that I have had time to |
17 | | read, or have had read to me, this Form and that I understand |
18 | | the Rights and Responsibilities described in this Form. I |
19 | | understand that if I do not receive any of my rights as |
20 | | described in said Form, it shall not constitute a basis to |
21 | | revoke this Final and Irrevocable Consent to Adoption by a |
22 | | Specified Person. |
23 | | 6. That I do hereby consent and agree to the adoption of |
24 | | such child by .... (specified persons) only. |
25 | | 7. That I wish to and understand that upon signing this |
26 | | consent I do irrevocably and permanently give up all custody |
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1 | | and other parental rights I have to such child if such child is |
2 | | adopted by .... (specified person or persons). I hereby |
3 | | transfer all of my rights to the custody, care and control of |
4 | | such child to ............................. (specified person |
5 | | or persons). |
6 | | 8. That I understand such child will be adopted by |
7 | | ....................... (specified person or persons) and that |
8 | | I cannot under any circumstances, after signing this document, |
9 | | change my mind and revoke or cancel this consent or obtain or |
10 | | recover custody or any other rights over such child if |
11 | | ............................ (specified person or persons) |
12 | | adopt(s) such child; PROVIDED that each specified person has |
13 | | filed or shall file, within 60 days from the date hereof, a |
14 | | petition for the adoption of such child. |
15 | | 9. That if the specified person or persons designated |
16 | | herein do not file a petition for adoption within the |
17 | | time-frame specified above, or, if said petition for adoption |
18 | | is filed within the time-frame specified above but the adoption |
19 | | petition is dismissed with prejudice or the adoption proceeding |
20 | | is otherwise concluded without an order declaring the child to |
21 | | be the adopted child of the specified person or persons, then I |
22 | | understand that I will receive written notice of such |
23 | | circumstances within 10 business days of their occurrence. I |
24 | | understand that the notice will be directed to me using the |
25 | | contact information I have provided in this consent. I |
26 | | understand that I will have 10 business days from the date that |
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1 | | the written notice is sent to me to respond, within which time |
2 | | I may request the Court to declare this consent voidable and |
3 | | return the child to me. I further understand that the Court |
4 | | will make the final decision of whether or not the child will |
5 | | be returned to me. If I do not make such request within 10 |
6 | | business days of the date of the notice, then I expressly waive |
7 | | any other notice or service of process in any legal proceeding |
8 | | for the adoption of the child. |
9 | | 10. That I expressly acknowledge that nothing in this |
10 | | Consent
impairs the validity and absolute finality of this
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11 | | Consent under any circumstance other than those described in
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12 | | paragraph 9 of this Consent. |
13 | | 11. That I understand that I have a remaining duty and
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14 | | obligation to keep .............. (insert name and address of |
15 | | the attorney
for the specified person or persons) informed of |
16 | | my current
address or other preferred contact information until |
17 | | this adoption has been finalized. My failure to
do so may |
18 | | result in the termination of my parental rights and
the child |
19 | | being placed for adoption in another home. |
20 | | 12. That I do expressly waive any other notice or service |
21 | | of process in any of the legal proceedings for the adoption of |
22 | | the child as long as the adoption proceeding by the specified |
23 | | person or persons is pending. |
24 | | 13. That I have read and understand the above and I am |
25 | | signing it as my free and voluntary act. |
26 | | 14. That I acknowledge that this consent is valid even if |
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1 | | the specified person or persons separate or divorce or one of |
2 | | the specified persons dies prior to the entry of the final |
3 | | judgment for adoption. |
4 | | Dated (insert date). |
5 | | ............................................. |
6 | | Signature of parent. |
7 | | ............................................. |
8 | | Address of parent. |
9 | | ............................................. |
10 | | Phone number(s) of parent. |
11 | | ............................................. |
12 | | Personal email(s) of parent. |
13 | | ............................................. |
14 | | (3) The form of the certificate of acknowledgement for a |
15 | | Final and Irrevocable Consent for Adoption by a Specified |
16 | | Person or Persons: Non-DCFS Case shall be substantially as |
17 | | follows:
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18 | | STATE OF ..............)
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19 | | ) SS.
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20 | | COUNTY OF .............) |
21 | | I, .................... (Name of Judge or other person), |
22 | | ..................... (official title, name, and address), |
23 | | certify that ............., personally known to me to be the |
24 | | same person whose name is subscribed to the foregoing Final and |
25 | | Irrevocable Consent for Adoption by a Specified Person or |
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1 | | Persons; non-DCFS case, appeared before me this day in person |
2 | | and acknowledged that (she)(he) signed and delivered the |
3 | | consent as (her)(his) free and voluntary act, for the specified |
4 | | purpose. I am further satisfied that, before signing this |
5 | | Consent, ........ has read, or has had read to him or her, the |
6 | | Birth Parent Rights and Responsibilities-Private Form. |
7 | | A-2. Birth Parent Rights and Responsibilities-Private |
8 | | Form. The Birth Parent Rights and Responsibilities-Private |
9 | | Form must be read by, or have been read to, any person |
10 | | executing a Final and Irrevocable Consent to Adoption under |
11 | | subsection A, a Final and Irrevocable Consent to Adoption by a |
12 | | Specified Person or Persons: Non-DCFS Case under subsection |
13 | | A-1, or a Consent to Adoption of Unborn Child under subsection |
14 | | B prior to the execution of said Consent. The form of the Birth |
15 | | Parent Rights and Responsibilities-Private Form shall be |
16 | | substantially as follows: |
17 | | Birth Parent Rights and Responsibilities-Private Form |
18 | | As a birth parent in the State of Illinois, you have the |
19 | | right: |
20 | | 1. To have your own attorney represent you. The prospective |
21 | | adoptive parents may agree to pay for the cost of your attorney |
22 | | in a manner consistent with Illinois law, but they are not |
23 | | required to do so. |
24 | | 2. To be treated with dignity and respect at all times and |
25 | | to make decisions free from coercion and pressure. |
26 | | 3. To receive counseling before and after signing a Final |
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1 | | and Irrevocable Consent to Adoption ("Consent"), a Final and |
2 | | Irrevocable Consent to Adoption by a Specified Person or |
3 | | Persons: Non-DCFS Case ("Specified Consent"), or a Consent to |
4 | | Adoption of Unborn Child ("Unborn Consent"). The prospective |
5 | | adoptive parents may agree to pay for the cost of counseling in |
6 | | a manner consistent with Illinois law, but they are not |
7 | | required to do so. |
8 | | 4. To ask to be involved in choosing your child's |
9 | | prospective adoptive parents and to ask to meet them. |
10 | | 5. To ask your child's prospective adoptive parents any |
11 | | questions that pertain to your decision to place your child |
12 | | with them. |
13 | | 6. To see your child before signing a Consent or Specified |
14 | | Consent. |
15 | | 7. To request contact with your child and/or the child's |
16 | | prospective adoptive parents, with the understanding that any |
17 | | promises regarding contact with your child or receipt of |
18 | | information about the child after signing a Consent, Specified |
19 | | Consent, or Unborn Consent cannot be enforced under Illinois |
20 | | law. |
21 | | 8. To receive copies of all documents that you sign and |
22 | | have those documents provided to you in your preferred |
23 | | language. |
24 | | 9. To request that your identifying information remain |
25 | | confidential, unless required otherwise by Illinois law or |
26 | | court order, and to register with the Illinois Adoption |
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1 | | Registry and Medical Information Exchange. |
2 | | 10. To work with an adoption agency or attorney of your |
3 | | choice, or change said agency or attorney, provided you |
4 | | promptly inform all of the parties currently involved. |
5 | | 11. To receive, upon request, a written list of any |
6 | | promised support, financial or otherwise, from your attorney or |
7 | | the attorney for your child's prospective adoptive parents. |
8 | | 12. To delay signing a Consent, Specified Consent, or |
9 | | Unborn Consent if you are not ready to do so. |
10 | | 13. To decline to sign a Consent, Specified Consent, or |
11 | | Unborn Consent even if you have received financial support from |
12 | | the prospective adoptive parents. |
13 | | If you do not receive any of the rights described in this |
14 | | Form, it shall not be a basis to revoke a Consent, Specified |
15 | | Consent, or Unborn Consent. |
16 | | As a Birth Parent in the State of Illinois, you have the |
17 | | responsibility: |
18 | | 1. To carefully consider your reasons for choosing |
19 | | adoption. |
20 | | 2. To voluntarily provide all known medical, background, |
21 | | and family information about yourself and your immediate family |
22 | | to your child's prospective adoptive parents or their attorney. |
23 | | For the health of your child, you are strongly encouraged, but |
24 | | not required, to provide all known medical, background, and |
25 | | family history information about yourself and your family to |
26 | | your child's prospective adoptive parents or their attorney. |
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1 | | 3. (Birth mothers only) To accurately complete an Affidavit |
2 | | of Identification, which identifies the father of the child |
3 | | when known, with the understanding that a birth mother has a |
4 | | right to decline to identify the birth father. |
5 | | 4. To not accept financial support or reimbursement of |
6 | | pregnancy related expenses simultaneously from more than one |
7 | | source. |
8 | | B. The form of consent required for the adoption of an |
9 | | unborn child
shall be substantially as follows:
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10 | | CONSENT TO ADOPTION OF UNBORN CHILD
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11 | | I, ...., state:
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12 | | That I am the father of a child expected to be born on or |
13 | | about ....
to .... (name of mother).
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14 | | That I reside at .... County of ...., and State of .....
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15 | | That I am of the age of .... years.
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16 | | That I hereby enter my appearance in such adoption |
17 | | proceeding and
waive service of summons on me.
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18 | | That I hereby acknowledge that I have been provided with a |
19 | | copy of the Birth Parent Rights and Responsibilities-Private |
20 | | Form before signing this Consent, and that I have had time to |
21 | | read, or have had read to me, this Form. I understand that if I |
22 | | do not receive any of the rights as described in this Form, it |
23 | | shall not constitute a basis to revoke this Consent to Adoption |
24 | | of Unborn Child. |
25 | | That I do hereby consent and agree to the adoption of such |
26 | | child, and
that I have not previously executed a consent or |
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1 | | surrender with respect
to such child.
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2 | | That I wish to and do understand that by signing this |
3 | | consent I do
irrevocably and permanently give up all custody |
4 | | and other parental
rights I have to such child, except that I |
5 | | have the right to revoke this
consent by giving written notice |
6 | | of my revocation not later than 72
hours after the birth of the |
7 | | child.
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8 | | That I understand such child will be placed for adoption |
9 | | and that,
except as hereinabove provided, I cannot under any |
10 | | circumstances, after
signing this document, change my mind and |
11 | | revoke or cancel this consent
or obtain or recover custody or |
12 | | any other rights over such child.
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13 | | That I have read and understand the above and I am signing |
14 | | it as my
free and voluntary act.
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15 | | Dated (insert date).
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16 | | ........................
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17 | | B-5. (1) The parent of a child may execute a consent to |
18 | | standby
adoption by a specified person or persons. A consent |
19 | | under this subsection B-5
shall be acknowledged by a parent |
20 | | pursuant to subsection H and subsection K of
this Section.
The |
21 | | form of consent required for the standby adoption of a born |
22 | | child
effective at a future date when the consenting
parent of |
23 | | the child dies or
requests that a final judgment of adoption be |
24 | | entered shall be substantially as
follows:
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25 | | FINAL AND IRREVOCABLE CONSENT
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26 | | TO STANDBY ADOPTION
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1 | | I, ..., (relationship, e.g. mother or father)
of ...., a |
2 | | ..male child, state:
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3 | | That the child was born on .... at .....
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4 | | That I reside at ...., County of ...., and State of .....
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5 | | That I am of the age of .... years.
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6 | | That I hereby enter my appearance in this proceeding and |
7 | | waive service of
summons on me in this action only.
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8 | | That I do hereby consent and
agree to the standby adoption |
9 | | of the child, and that I have not previously
executed a consent |
10 | | or surrender with respect to the child.
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11 | | That I wish to and understand that by signing this consent |
12 | | I do irrevocably
and permanently give up all custody and other |
13 | | parental rights I have to the
child, effective upon
(my death) |
14 | | (the child's other parent's death) or upon (my) (the other
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15 | | parent's) request for the entry of a final judgment for |
16 | | adoption if .....
(specified person or persons) adopt my child.
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17 | | That I understand that until (I die) (the child's other |
18 | | parent dies), I
retain all legal rights and obligations |
19 | | concerning the child, but at that time,
I irrevocably give all |
20 | | custody and other parental rights to .... (specified
person or |
21 | | persons).
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22 | | I understand my child will be adopted by ....... (specified |
23 | | person or
persons) only and that I cannot, under any |
24 | | circumstances, after signing this
document, change my mind and |
25 | | revoke or cancel this consent or obtain or recover
custody or |
26 | | any other rights over my child if ..... (specified person or
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1 | | persons) adopt my child.
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2 | | I understand that this consent to standby adoption is valid |
3 | | only if the
petition for standby adoption is filed and that if |
4 | | ....... (specified person or
persons), for any reason, cannot |
5 | | or will not file a petition for standby
adoption or if his, |
6 | | her, or their petition for standby adoption is denied, then
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7 | | this consent is void. I have the right to notice of any other |
8 | | proceeding that
could affect my parental rights.
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9 | | That I have read and understand the above and I am signing |
10 | | it as my free and
voluntary act.
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11 | | Dated (insert date).
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12 | | ....................
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13 | | If under Section 8 the consent of more than one person is |
14 | | required, then each
such
person shall execute a separate |
15 | | consent. A separate consent shall be executed
for each
child.
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16 | | (2) If the parent consents to a standby adoption by 2 |
17 | | specified persons,
then the form shall contain 2 additional |
18 | | paragraphs in substantially the
following form:
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19 | | If .... (specified persons) obtain a judgment of
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20 | | dissolution of
marriage before the judgment for adoption is |
21 | | entered, then .....
(specified person) shall adopt my child. I |
22 | | understand that I cannot change my
mind and revoke this consent |
23 | | or obtain or recover custody of my child if .....
(specified |
24 | | persons) obtain a judgment of dissolution of marriage and .....
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25 | | (specified person) adopts my child. I understand that I cannot |
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1 | | change my
mind and revoke this consent if ...... (specified |
2 | | persons) obtain a
judgment of dissolution of marriage before |
3 | | the adoption is final. I
understand that this consent to |
4 | | adoption has no effect on who will get custody
of my child if |
5 | | ..... (specified persons) obtain a judgment of dissolution
of |
6 | | marriage after the adoption is final. I understand that if |
7 | | either .....
(specified persons) dies before the petition to |
8 | | adopt my child is granted, then
the surviving person may adopt |
9 | | my child. I understand that I cannot change my
mind and revoke |
10 | | this consent or obtain or recover custody of my child if the
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11 | | surviving person adopts my child.
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12 | | A consent to standby adoption by specified persons on this |
13 | | form shall have no
effect on a court's determination of custody |
14 | | or visitation under the Illinois
Marriage and Dissolution
of |
15 | | Marriage Act if the marriage of the specified persons is |
16 | | dissolved before
the adoption is final.
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17 | | (3) The form of the certificate of acknowledgement for a |
18 | | Final and
Irrevocable Consent for Standby Adoption shall be |
19 | | substantially as follows:
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20 | | STATE OF .....)
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21 | | ) SS.
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22 | | COUNTY OF ....)
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23 | | I, ....... (name of Judge or other person) ..... (official |
24 | | title,
name, and address), certify that ......., personally |
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1 | | known to me to be
the same person whose name is subscribed to |
2 | | the foregoing Final and Irrevocable
Consent to Standby |
3 | | Adoption, appeared before me this day in person and
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4 | | acknowledged that (she) (he) signed and
delivered the consent |
5 | | as (her) (his) free and voluntary act, for the specified
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6 | | purpose.
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7 | | I have fully explained that this consent to adoption is |
8 | | valid only if the
petition to adopt is filed, and that if the |
9 | | specified person or persons, for
any reason, cannot or will not |
10 | | adopt the child or if the adoption petition is
denied, then |
11 | | this consent will be void. I have fully explained that if the
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12 | | specified person or persons adopt the child, by signing this |
13 | | consent (she) (he)
is irrevocably and permanently |
14 | | relinquishing all parental rights to the child,
and (she) (he) |
15 | | has stated that such is (her) (his) intention and desire.
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16 | | Dated (insert date).
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17 | | Signature ..............................
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18 | | (4) If a consent to standby adoption is executed in this |
19 | | form,
the consent shall be valid only if the specified
person |
20 | | or persons adopt the child. The consent shall be void if:
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21 | | (a) the specified person or persons do not file a petition |
22 | | for standby
adoption of the child; or
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23 | | (b) a court denies the standby adoption petition.
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24 | | The parent shall not need to take further action to revoke |
25 | | the consent if the
standby adoption by the specified person or |
26 | | persons does not occur,
notwithstanding the provisions of |
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1 | | Section 11 of this Act.
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2 | | C. The form of surrender to any agency given by a parent of |
3 | | a born
child who is to be subsequently placed for adoption |
4 | | shall be
substantially as follows and shall contain such other |
5 | | facts and
statements as the particular agency shall require.
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6 | | FINAL AND IRREVOCABLE SURRENDER
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7 | | FOR PURPOSES OF ADOPTION
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8 | | I, .... (relationship, e.g., mother, father, relative, |
9 | | guardian) of
...., a ..male child, state:
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10 | | That such child was born on ...., at .....
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11 | | That I reside at ...., County of ...., and State of .....
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12 | | That I am of the age of .... years.
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13 | | That I do hereby surrender and entrust the entire custody |
14 | | and control
of such child to the .... (the "Agency"), a |
15 | | (public) (licensed) child
welfare agency with its principal |
16 | | office in the City of ...., County of
.... and State of ...., |
17 | | for the purpose of enabling it to care for and
supervise the |
18 | | care of such child, to place such child for adoption and
to |
19 | | consent to the legal adoption of such child.
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20 | | That I hereby grant to the Agency full power and authority |
21 | | to place
such child with any person or persons it may in its |
22 | | sole discretion
select to become the adopting parent or parents |
23 | | and to consent to the
legal adoption of such child by such |
24 | | person or persons; and to take any
and all measures which, in |
25 | | the judgment of the Agency, may be for the
best interests of |
26 | | such child, including authorizing medical, surgical
and dental |
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1 | | care and treatment including inoculation and anaesthesia for
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2 | | such child.
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3 | | That I wish to and understand that by signing this |
4 | | surrender I do
irrevocably and permanently give up all custody |
5 | | and other parental
rights I have to such child.
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6 | | That I understand I cannot under any circumstances, after |
7 | | signing
this surrender, change my mind and revoke or cancel |
8 | | this surrender or
obtain or recover custody or any other rights |
9 | | over such child.
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10 | | That I have read and understand the above and I am signing |
11 | | it as my
free and voluntary act.
|
12 | | Dated (insert date).
|
13 | | ........................
|
14 | | C-5. The form of a Final and Irrevocable Designated |
15 | | Surrender for Purposes of Adoption to any agency given by a |
16 | | parent of a born child who is to be subsequently placed for |
17 | | adoption shall be substantially as follows and shall contain |
18 | | such other facts and statements as the particular agency shall |
19 | | require: |
20 | | FINAL AND IRREVOCABLE DESIGNATED SURRENDER |
21 | | FOR PURPOSES OF ADOPTION |
22 | | I, .... (relationship, e.g., mother, father, relative, |
23 | | guardian) of ...., a ..male child, state: |
24 | | 1. That such child was born on ...., at ..... |
25 | | 2. That I reside at ...., County of ...., and State of |
26 | | ..... |
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1 | | 3. That I am of the age of .... years. |
2 | | 4. That I do hereby surrender and entrust the entire |
3 | | custody and control of such child to the .... (the "Agency"), a |
4 | | (public) (licensed) child welfare agency with its principal |
5 | | office in the City of ...., County of .... and State of ...., |
6 | | for the purpose of enabling it to care for and supervise the |
7 | | care of such child, to place such child for adoption with |
8 | | ............................. (specified person or persons) |
9 | | and to consent to the legal adoption of such child and to take |
10 | | any and all measures which, in the judgment of the Agency, may |
11 | | be for the best interests of such child, including authorizing |
12 | | medical, surgical and dental care and treatment including |
13 | | inoculation and anesthesia for such child. |
14 | | 5. That I wish to and understand that by signing this |
15 | | surrender I do irrevocably and permanently give up all custody |
16 | | and other parental rights I have to such child. |
17 | | 6. That if the petition for adoption is not filed by the
|
18 | | specified person or persons designated herein or, if the
|
19 | | petition for adoption is filed but the adoption petition is
|
20 | | dismissed with prejudice or the adoption proceeding is
|
21 | | otherwise concluded without an order declaring the child to be
|
22 | | the adopted child of each specified person, then I understand |
23 | | that the Agency will provide notice to me within 10 business |
24 | | days and that such notice will be directed to me using the |
25 | | contact information I have provided to the Agency. I understand |
26 | | that I will have 10 business days from the date that the Agency |
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1 | | sends me its notice to respond, within which time I may choose |
2 | | to designate other adoptive parent(s). However, I acknowledge |
3 | | that
the Agency has full power and authority to place the child |
4 | | for adoption with
any person or persons it may in its sole |
5 | | discretion select to
become the adopting parent or parents and |
6 | | to consent to the
legal adoption of the child by such person or |
7 | | persons. |
8 | | 7. That I acknowledge that this surrender is valid even if |
9 | | the specified persons separate or divorce or one of the |
10 | | specified persons dies prior to the entry of the final judgment |
11 | | for adoption. |
12 | | 8. That I expressly acknowledge that the above paragraphs 6 |
13 | | and 7 do not impair the validity and absolute finality of this |
14 | | surrender under any circumstance. |
15 | | 9. That I understand that I have a remaining obligation to |
16 | | keep the Agency informed of my current contact information |
17 | | until the adoption of the child has been finalized if I wish to |
18 | | be notified in the event the adoption by the specified |
19 | | person(s) cannot proceed. |
20 | | 10. That I understand I cannot under any circumstances, |
21 | | after signing this surrender, change my mind and revoke or |
22 | | cancel this surrender or obtain or recover custody or any other |
23 | | rights over such child. |
24 | | 11. That I have read and understand the above and I am |
25 | | signing it as my free and voluntary act. |
26 | | Dated (insert date). |
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1 | | .............................. |
2 | | D. The form of surrender to an agency given by a parent of |
3 | | an unborn
child who is to be subsequently placed for adoption |
4 | | shall be
substantially as follows and shall contain such other |
5 | | facts and
statements as the particular agency shall require.
|
6 | | SURRENDER OF UNBORN CHILD FOR
|
7 | | PURPOSES OF ADOPTION
|
8 | | I, .... (father), state:
|
9 | | That I am the father of a child expected to be born on or |
10 | | about ....
to .... (name of mother).
|
11 | | That I reside at ...., County of ...., and State of .....
|
12 | | That I am of the age of .... years.
|
13 | | That I do hereby surrender and entrust the entire custody |
14 | | and control
of such child to the .... (the "Agency"), a |
15 | | (public) (licensed) child
welfare agency with its principal |
16 | | office in the City of ...., County of
.... and State of ...., |
17 | | for the purpose of enabling it to care for and
supervise the |
18 | | care of such child, to place such child for adoption and
to |
19 | | consent to the legal adoption of such child, and that I have |
20 | | not
previously executed a consent or surrender with respect to |
21 | | such child.
|
22 | | That I hereby grant to the Agency full power and authority |
23 | | to place
such child with any person or persons it may in its |
24 | | sole discretion
select to become the adopting parent or parents |
25 | | and to consent to the
legal adoption of such child by such |
26 | | person or persons; and to take any
and all measures which, in |
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1 | | the judgment of the Agency, may be for the
best interests of |
2 | | such child, including authorizing medical, surgical
and dental |
3 | | care and treatment, including inoculation and anaesthesia for
|
4 | | such child.
|
5 | | That I wish to and understand that by signing this |
6 | | surrender I do
irrevocably and permanently give up all custody |
7 | | and other parental
rights I have to such child.
|
8 | | That I understand I cannot under any circumstances, after |
9 | | signing
this surrender, change my mind and revoke or cancel |
10 | | this surrender or
obtain or recover custody or any other rights |
11 | | over such child, except
that I have the right to revoke this |
12 | | surrender by giving written notice
of my revocation not later |
13 | | than 72 hours after the birth of such child.
|
14 | | That I have read and understand the above and I am signing |
15 | | it as my
free and voluntary act.
|
16 | | Dated (insert date).
|
17 | | ........................
|
18 | | E. The form of consent required from the parents for the |
19 | | adoption of
an adult, when such adult elects to obtain such |
20 | | consent, shall be
substantially as follows:
|
21 | | CONSENT
|
22 | | I, ...., (father) (mother) of ...., an adult, state:
|
23 | | That I reside at ...., County of .... and State of .....
|
24 | | That I do hereby consent and agree to the adoption of such |
25 | | adult by
.... and .....
|
26 | | Dated (insert date).
|
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1 | | .........................
|
2 | | F. The form of consent required for the adoption of a child |
3 | | of the
age of 14 years or upwards, or of an adult, to be given |
4 | | by such person,
shall be substantially as follows:
|
5 | | CONSENT
|
6 | | I, ...., state:
|
7 | | That I reside at ...., County of .... and State of ..... |
8 | | That I am
of the age of .... years. That I consent and agree to |
9 | | my adoption by
.... and .....
|
10 | | Dated (insert date).
|
11 | | ........................
|
12 | | G. The form of consent given by an agency to the adoption |
13 | | by
specified persons of a child previously surrendered to it |
14 | | shall set
forth that the agency has the authority to execute |
15 | | such consent. The
form of consent given by a guardian of the |
16 | | person of a child sought to
be adopted, appointed by a court of |
17 | | competent jurisdiction, shall set
forth the facts of such |
18 | | appointment and the authority of the guardian to
execute such |
19 | | consent.
|
20 | | H. A consent (other than that given by an agency, or |
21 | | guardian of the
person of the child sought to be adopted who |
22 | | was appointed by a court of
competent jurisdiction) shall be |
23 | | acknowledged by a parent before a judge of a court of competent |
24 | | jurisdiction or, except as otherwise provided in
this Act, |
25 | | before a representative of an agency, or before a person, other |
26 | | than the attorney for the prospective adoptive parent or |
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1 | | parents, designated by a court of competent
jurisdiction.
|
2 | | I. A surrender, or any other document equivalent to a |
3 | | surrender, by
which a child is surrendered to an agency shall |
4 | | be acknowledged by the
person signing such surrender, or other |
5 | | document, before a judge of a court of competent jurisdiction, |
6 | | or, except as otherwise provided in this Act, before a |
7 | | representative of an agency, or before a person designated by a |
8 | | court
of competent jurisdiction.
|
9 | | J. The form of the certificate of acknowledgment for a |
10 | | consent, a
surrender, or any other document equivalent to a |
11 | | surrender, shall be
substantially as follows:
|
12 | | STATE OF ....)
|
13 | | ) SS.
|
14 | | COUNTY OF ...)
|
15 | | I, .... (Name of judge or other person), .... (official |
16 | | title, name and
location of court or status or position of |
17 | | other person),
certify that ...., personally known to me to be |
18 | | the same person whose
name is subscribed to the foregoing |
19 | | (consent) (surrender), appeared
before me this day in person |
20 | | and acknowledged that (she) (he) signed and
delivered such |
21 | | (consent) (surrender) as (her) (his) free and voluntary
act, |
22 | | for the specified purpose.
|
23 | | I have fully explained that by signing such (consent) |
24 | | (surrender)
(she) (he) is irrevocably relinquishing all |
25 | | parental rights to such
child or adult and (she) (he) has |
26 | | stated that such is (her) (his)
intention and desire. (Add if |
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1 | | Consent only) I am further satisfied that, before signing this |
2 | | Consent, ........ has read, or has had read to him or her, the |
3 | | Birth Parent Rights and Responsibilities-Private Form.
|
4 | | Dated (insert date).
|
5 | | Signature ...............
|
6 | | K. When the execution of a consent or a surrender is |
7 | | acknowledged
before someone other than a judge,
such other |
8 | | person shall have his or her signature on the certificate
|
9 | | acknowledged before a notary public, in form substantially as |
10 | | follows:
|
11 | | STATE OF ....)
|
12 | | ) SS.
|
13 | | COUNTY OF ...)
|
14 | | I, a Notary Public, in and for the County of ......, in the |
15 | | State of
......, certify that ...., personally known to me to |
16 | | be the
same person whose name is subscribed to the foregoing |
17 | | certificate of
acknowledgment, appeared before me in person and |
18 | | acknowledged that (she)
(he) signed such certificate as (her) |
19 | | (his) free and voluntary act and
that the statements made in |
20 | | the certificate are true.
|
21 | | Dated (insert date).
|
22 | | Signature ...................... Notary Public
|
23 | | (official seal)
|
24 | | There shall be attached a certificate of magistracy, or |
25 | | other
comparable proof of office of the notary public |
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1 | | satisfactory to the
court, to a consent signed and acknowledged |
2 | | in another state.
|
3 | | L. A surrender or consent executed and acknowledged outside |
4 | | of this
State, either in accordance with the law of this State |
5 | | or in accordance
with the law of the place where executed, is |
6 | | valid.
|
7 | | M. Where a consent or a surrender is signed in a foreign |
8 | | country,
the execution of such consent shall be acknowledged or |
9 | | affirmed in a
manner conformable to the law and procedure of |
10 | | such country.
|
11 | | N. If the person signing a consent or surrender is in the |
12 | | military
service of the United States, the execution of such |
13 | | consent or surrender
may be acknowledged before a commissioned |
14 | | officer and the signature of
such officer on such certificate |
15 | | shall be verified or acknowledged
before a notary public or by |
16 | | such other procedure as is then in effect
for such division or |
17 | | branch of the armed forces.
|
18 | | O. (1) The parent or parents of a child in whose interests |
19 | | a petition
under Section 2-13 of the Juvenile Court Act of 1987 |
20 | | is pending may, with the
approval of the designated |
21 | | representative of the Department of Children and
Family |
22 | | Services, execute a consent to adoption by a specified person |
23 | | or
persons:
|
24 | | (a) in whose physical custody the child has resided for |
25 | | at least 6
months;
or
|
26 | | (b) in whose physical custody at least one sibling of |
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1 | | the child who is the
subject of this consent has resided |
2 | | for at least 6 months, and
the child who is
the subject of |
3 | | this consent is currently residing in this foster home; or
|
4 | | (c) in whose physical custody a child under one year of |
5 | | age has resided
for at least 3 months.
|
6 | | A consent under this subsection O shall be acknowledged by a |
7 | | parent pursuant to
subsection H and subsection K of this |
8 | | Section.
|
9 | | (2) The consent to adoption by a specified person or |
10 | | persons shall have the
caption of the proceeding in which it is |
11 | | to be filed and shall be substantially
as follows:
|
12 | | FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY
|
13 | | A SPECIFIED PERSON OR PERSONS: DCFS CASE
|
14 | | I, ......................................, the |
15 | | .................. (mother or
father) of a ....male child, |
16 | | state:
|
17 | | My child ............................ (name of child) |
18 | | was born on
(insert date) at .................... Hospital |
19 | | in
................ County, State of ...............
|
20 | | I reside at ......................, County of |
21 | | ............. and
State of ..............
|
22 | | I, ..........................., am .... years old.
|
23 | | I enter my appearance in this action to adopt my child |
24 | | by the
person or persons specified herein by me and waive |
25 | | service of
summons on me in this action only.
|
26 | | I consent to the adoption of my child by
|
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1 | | .............................
(specified person or |
2 | | persons) only.
|
3 | | I wish to sign this consent and I understand that by |
4 | | signing this
consent I irrevocably and permanently give up |
5 | | all parental rights I have to my
child if my child is |
6 | | adopted by ............................. (specified person
|
7 | | or persons).
|
8 | | I understand my child will be adopted by |
9 | | .............................
(specified person or |
10 | | persons) only and that I cannot under any circumstances,
|
11 | | after signing this document, change my mind and revoke or |
12 | | cancel this consent
or obtain or recover custody or any |
13 | | other rights over my child if
............................ |
14 | | (specified person or persons) adopt my child.
|
15 | | I understand that this consent to adoption is valid |
16 | | only if the
petition to adopt is filed within one year from |
17 | | the date that I sign it and
that if ....................... |
18 | | (specified person or persons), for any reason,
cannot or |
19 | | will not file a petition to adopt my child within that one |
20 | | year
period or if their adoption petition is denied, then |
21 | | this consent will be
voidable after one year upon the |
22 | | timely filing of my motion. If I file this
motion before |
23 | | the filing of the petition for adoption, I understand that |
24 | | the
court shall revoke this specific consent.
I have the |
25 | | right to notice of any other proceeding that could affect |
26 | | my
parental rights, except for the proceeding for |
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1 | | ............. (specified person
or persons) to adopt my |
2 | | child.
|
3 | | I have read and understand the above and I am signing |
4 | | it as my free
and voluntary act.
|
5 | | Dated (insert date).
|
6 | | .............................................
|
7 | | Signature of parent
|
8 | | (3) If the parent consents to an adoption by 2 specified |
9 | | persons, then the
form shall contain 2 additional paragraphs in |
10 | | substantially the following form:
|
11 | | If ............... (specified persons) get a divorce
|
12 | | before the petition to adopt my child is granted, then |
13 | | ..........
(specified person) shall adopt my child. I |
14 | | understand that I
cannot change my mind and revoke this |
15 | | consent or obtain or
recover custody over my child if |
16 | | ............. (specified persons)
divorce and |
17 | | ............. (specified person) adopts my
child. I |
18 | | understand that I cannot change my mind and revoke
this |
19 | | consent or obtain or recover custody over my child if
|
20 | | ................. (specified persons) divorce after the
|
21 | | adoption is final. I understand that this consent to |
22 | | adoption
has no effect on who will get custody of my child |
23 | | if they
divorce after the adoption is final.
|
24 | | I understand that if either ...............
|
25 | | (specified persons) dies before the petition to adopt
my |
26 | | child is granted, then the surviving person can adopt my |
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1 | | child. I
understand that I cannot change my mind and revoke |
2 | | this consent
or obtain or recover custody over my child if |
3 | | the surviving
person adopts my child.
|
4 | | A consent to adoption by specified persons on this form |
5 | | shall
have no effect on a court's determination of custody or |
6 | | visitation
under the Illinois Marriage and Dissolution of |
7 | | Marriage Act if the
marriage of the
specified persons is |
8 | | dissolved after the adoption is final.
|
9 | | (4) The form of the certificate of acknowledgement for a |
10 | | Final and
Irrevocable Consent for Adoption by a Specified |
11 | | Person or Persons: DCFS Case shall be
substantially as follows:
|
12 | | STATE OF ..............)
|
13 | | ) SS.
|
14 | | COUNTY OF .............)
|
15 | | I, .................... (Name of Judge or other person),
|
16 | | ..................... (official title, name, and address),
|
17 | | certify that ............., personally known to me to be the |
18 | | same person whose
name is subscribed to the foregoing Final and |
19 | | Irrevocable Consent for Adoption
by a Specified Person or |
20 | | Persons, appeared before me this day
in person and acknowledged |
21 | | that (she)(he) signed and delivered the consent as
(her)(his) |
22 | | free and voluntary act, for the specified purpose.
|
23 | | I have fully explained that this consent to adoption is |
24 | | valid only if the
petition to adopt is filed within one year |
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1 | | from the date that it is signed, and
that if the specified |
2 | | person or persons, for any reason, cannot or will not
adopt the |
3 | | child or if the adoption petition is denied, then this consent |
4 | | will
be voidable after one year upon the timely filing of a |
5 | | motion by the parent
to revoke the consent. I explained that if |
6 | | this motion is filed before the
filing of the petition for |
7 | | adoption, the court shall revoke this specific
consent. I have |
8 | | fully explained that if the specified person or
persons adopt
|
9 | | the child, by signing this consent this parent is irrevocably
|
10 | | and permanently
relinquishing all parental rights to the child, |
11 | | and this parent has stated that
such is (her)(his) intention |
12 | | and desire.
|
13 | | Dated (insert date).
|
14 | | ...............................
|
15 | | Signature
|
16 | | (5) If a consent to adoption by a specified person or |
17 | | persons is executed in
this form, the following provisions |
18 | | shall apply. The consent shall be valid
only if that specified |
19 | | person or persons adopt the child. The consent shall be
|
20 | | voidable after one year if:
|
21 | | (a) the specified person or persons do not file a |
22 | | petition to adopt the
child within one year after the |
23 | | consent is signed and the parent files a
timely motion to |
24 | | revoke this consent. If this motion is filed before the
|
25 | | filing of the petition for adoption the court shall revoke |
26 | | this consent; or
|
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1 | | (b) a court denies the adoption petition; or
|
2 | | (c) the Department of Children and Family Services |
3 | | Guardianship
Administrator determines that the specified |
4 | | person or persons will not or
cannot complete the adoption, |
5 | | or in the best interests of the child should not
adopt the |
6 | | child.
|
7 | | Within 30 days of the consent becoming void, the Department |
8 | | of Children and
Family Services Guardianship Administrator |
9 | | shall make good faith attempts to
notify the parent in writing |
10 | | and shall give written notice to the court and all
additional |
11 | | parties in writing that the adoption has not occurred or will |
12 | | not
occur and that the consent is void. If the adoption by a |
13 | | specified person or
persons does not occur, no proceeding for |
14 | | termination of parental rights shall
be brought unless the |
15 | | biological parent who executed the consent to adoption by
a |
16 | | specified person or persons has been notified of the proceeding |
17 | | pursuant to
Section 7 of this Act or subsection (4) of Section |
18 | | 2-13 of the Juvenile Court
Act of 1987. The parent shall not |
19 | | need to take further action to revoke the
consent if the |
20 | | specified adoption does not occur, notwithstanding the
|
21 | | provisions of Section 11 of this Act.
|
22 | | (6) The Department of Children and Family Services is |
23 | | authorized
to promulgate rules necessary to implement this |
24 | | subsection O.
|
25 | | (7) The Department shall collect and maintain data |
26 | | concerning the efficacy
of specific consents. This data shall |
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| | HB1698 | - 32 - | LRB097 07917 AJO 48032 b |
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|
1 | | include the number of specific consents
executed and their |
2 | | outcomes, including but not limited to the number of
children |
3 | | adopted pursuant to the consents, the number of children for |
4 | | whom
adoptions are not completed, and the reason or reasons why |
5 | | the adoptions are
not completed.
|
6 | | P. If the person signing a consent is incarcerated or |
7 | | detained in a correctional facility, prison, jail, detention |
8 | | center, or other comparable institution, either in this State |
9 | | or any other jurisdiction, the execution of such consent may be |
10 | | acknowledged before social service personnel of such |
11 | | institution, or before a person designated by a court of |
12 | | competent jurisdiction. |
13 | | Q. A consent may be acknowledged telephonically, via |
14 | | audiovisual connection, or other electronic means, provided |
15 | | that a court of competent jurisdiction has entered an order |
16 | | approving the execution of the consent in such manner and has |
17 | | designated an individual to be physically present with the |
18 | | parent executing such consent in order to verify the identity |
19 | | of the parent. |
20 | | R. An agency whose representative is acknowledging a |
21 | | consent pursuant to this Section shall be a public child |
22 | | welfare agency, or a child welfare agency, or a child placing |
23 | | agency that is authorized or licensed in the State or |
24 | | jurisdiction in which the consent is signed. |
25 | | S. The form of waiver by a putative or legal father of a |
26 | | born or unborn child shall be substantially as follows:
|
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| | HB1698 | - 33 - | LRB097 07917 AJO 48032 b |
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1 | | FINAL AND IRREVOCABLE |
2 | | WAIVER OF PARENTAL RIGHTS OF PUTATIVE OR LEGAL FATHER
|
3 | | I, .................... , state under oath or affirm as |
4 | | follows: |
5 | | 1. That the biological mother ............... has |
6 | | named me as a possible biological or
legal father of her |
7 | | minor child who was born, or is expected to be born on
|
8 | | ..........., ....... in City/Town .......... of State of |
9 | | ........... |
10 | | 2. That I understand that the biological mother |
11 | | ............. intends to or has placed the child
for |
12 | | adoption. |
13 | | 3. That I reside at ................. in the City/Town |
14 | | ............
of State of ................ |
15 | | 4. That I am ................ years of age and my date |
16 | | of birth is ..............., ............. |
17 | | 5. That I (select one): |
18 | | ..... am married to the biological mother. |
19 | | ..... am not married to the biological mother and |
20 | | have not been married to the biological
mother within |
21 | | 300 days before the child's birth or expected date of |
22 | | child's birth. |
23 | | ..... am not currently married to the biological |
24 | | mother, but was married to the biological
mother, |
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| | HB1698 | - 34 - | LRB097 07917 AJO 48032 b |
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|
1 | | within 300 days before the child's birth or expected |
2 | | date of child's birth. |
3 | | 6. That I (select one) |
4 | | ..... neither admit nor deny that I am the |
5 | | biological father of the child. |
6 | | ..... deny that I am the biological father of the |
7 | | child. |
8 | | 7. That I hereby agree to the termination of my |
9 | | parental rights, if any, without further notice to me
of |
10 | | any proceeding for the adoption of the minor child, even if |
11 | | I have taken any action to establish
parental rights or |
12 | | take any such action in the future including registering |
13 | | with any putative father
registry. |
14 | | 8. That I understand that by signing this Waiver I do |
15 | | irrevocably and permanently give up all
custody and other |
16 | | parental rights I may have to such child. |
17 | | 9. That I understand that this Waiver is FINAL AND |
18 | | IRREVOCABLE and that I am permanently
barred from |
19 | | contesting any proceeding for the adoption of the child |
20 | | after I sign this Waiver. |
21 | | 10. That I waive any further service of summons or |
22 | | other pleadings in any proceeding to terminate
parental |
23 | | rights, if any to this child, or any proceeding for |
24 | | adoption of this child. |
25 | | 11. That I understand that if a final judgment or order |
26 | | of adoption for this child is not entered, then
any |
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| | HB1698 | - 35 - | LRB097 07917 AJO 48032 b |
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|
1 | | parental rights or responsibilities that I may have remain |
2 | | intact. |
3 | | 12. That I have read and understand the above and that |
4 | | I am signing it as my free and voluntary act.
|
5 | | Dated: ................... , .............. |
6 | | ........................................... |
7 | | Signature
|
8 | | OATH |
9 | | I have been duly sworn and I state under oath that I have read |
10 | | and understood this Final and Irrevocable
Waiver of Parental |
11 | | Rights of Putative or Legal Father. The facts contained in it |
12 | | are true and correct to the
best of my knowledge. I have signed |
13 | | this document as my free and voluntary act in order to |
14 | | facilitate the
adoption of the child.
|
15 | | .............................. |
16 | | Signature
|
17 | | Signed and Sworn before me on |
18 | | this ............ day |
19 | | of ............ 20....
|
20 | | ................... |
21 | | Notary Public |