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Public Act 097-1063 |
HB4028 Enrolled | LRB097 14710 AJO 61950 b |
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AN ACT concerning civil law.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Abused and Neglected Child Reporting Act is |
amended by changing Section 3 as follows: |
(325 ILCS 5/3) (from Ch. 23, par. 2053) |
Sec. 3. As used in this Act unless the context otherwise |
requires: |
"Adult resident" means any person between 18 and 22 years |
of age who resides in any facility licensed by the Department |
under the Child Care Act of 1969. For purposes of this Act, the |
criteria set forth in the definitions of "abused child" and |
"neglected child" shall be used in determining whether an adult |
resident is abused or neglected. |
"Child" means any person under the age of 18 years, unless |
legally
emancipated by reason of marriage or entry into a |
branch of the United
States armed services. |
"Department" means Department of Children and Family |
Services. |
"Local law enforcement agency" means the police of a city, |
town,
village or other incorporated area or the sheriff of an |
unincorporated
area or any sworn officer of the Illinois |
Department of State Police. |
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"Abused child"
means a child whose parent or immediate |
family
member,
or any person responsible for the child's |
welfare, or any individual
residing in the same home as the |
child, or a paramour of the child's parent: |
(a) inflicts, causes to be inflicted, or allows to be
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inflicted upon
such child physical injury, by other than |
accidental means, which causes
death, disfigurement, |
impairment of physical or
emotional health, or loss or |
impairment of any bodily function; |
(b) creates a substantial risk of physical injury to |
such
child by
other than accidental means which would be |
likely to cause death,
disfigurement, impairment of |
physical or emotional health, or loss or
impairment of any |
bodily function; |
(c) commits or allows to be committed any sex offense |
against
such child,
as such sex offenses are defined in the |
Criminal Code of 1961, as amended, or in the Wrongs to |
Children Act,
and extending those definitions of sex |
offenses to include children under
18 years of age; |
(d) commits or allows to be committed an act or acts of
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torture upon
such child; |
(e) inflicts excessive corporal punishment; |
(f) commits or allows to be committed
the offense of
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female
genital mutilation, as defined in Section 12-34 of |
the Criminal Code of
1961, against the child; |
(g) causes to be sold, transferred, distributed, or |
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given to
such child
under 18 years of age, a controlled |
substance as defined in Section 102 of the
Illinois |
Controlled Substances Act in violation of Article IV of the |
Illinois
Controlled Substances Act or in violation of the |
Methamphetamine Control and Community Protection Act, |
except for controlled substances that are prescribed
in |
accordance with Article III of the Illinois Controlled |
Substances Act and
are dispensed to such child in a manner |
that substantially complies with the
prescription; or |
(h) commits or allows to be committed the offense of |
involuntary servitude, involuntary sexual servitude of a |
minor, or trafficking in persons for forced labor or |
services as defined in Section 10-9 of the Criminal Code of |
1961 against the child. |
A child shall not be considered abused for the sole reason |
that the child
has been relinquished in accordance with the |
Abandoned Newborn Infant
Protection Act. |
"Neglected child" means any child who is not receiving the |
proper or
necessary nourishment or medically indicated |
treatment including food or care
not provided solely on the |
basis of the present or anticipated mental or
physical |
impairment as determined by a physician acting alone or in
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consultation with other physicians or otherwise is not |
receiving the proper or
necessary support or medical or other |
remedial care recognized under State law
as necessary for a |
child's well-being, or other care necessary for his or her
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well-being, including adequate food, clothing and shelter; or |
who is abandoned
by his or her parents or other person |
responsible for the child's welfare
without a proper plan of |
care; or who has been provided with interim crisis intervention |
services under
Section 3-5 of
the Juvenile Court Act of 1987 |
and whose parent, guardian, or custodian refuses to
permit
the |
child to return home and no other living arrangement agreeable
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to the parent, guardian, or custodian can be made, and the |
parent, guardian, or custodian has not made any other |
appropriate living arrangement for the child; or who is a |
newborn infant whose blood, urine,
or meconium
contains any |
amount of a controlled substance as defined in subsection (f) |
of
Section 102 of the Illinois Controlled Substances Act or a |
metabolite thereof,
with the exception of a controlled |
substance or metabolite thereof whose
presence in the newborn |
infant is the result of medical treatment administered
to the |
mother or the newborn infant. A child shall not be considered |
neglected
for the sole reason that the child's parent or other |
person responsible for his
or her welfare has left the child in |
the care of an adult relative for any
period of time. A child |
shall not be considered neglected for the sole reason
that the |
child has been relinquished in accordance with the Abandoned |
Newborn
Infant Protection Act. A child shall not be considered |
neglected or abused
for the
sole reason that such child's |
parent or other person responsible for his or her
welfare |
depends upon spiritual means through prayer alone for the |
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treatment or
cure of disease or remedial care as provided under |
Section 4 of this Act. A
child shall not be considered |
neglected or abused solely because the child is
not attending |
school in accordance with the requirements of Article 26 of The
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School Code, as amended. |
"Child Protective Service Unit" means certain specialized |
State employees of
the Department assigned by the Director to |
perform the duties and
responsibilities as provided under |
Section 7.2 of this Act. |
"Person responsible for the child's welfare" means the |
child's parent;
guardian; foster parent; relative caregiver; |
any person responsible for the
child's welfare in a public or |
private residential agency or institution; any
person |
responsible for the child's welfare within a public or private |
profit or
not for profit child care facility; or any other |
person responsible for the
child's welfare at the time of the |
alleged abuse or neglect, including any person that is the |
custodian of a child under 18 years of age who commits or |
allows to be committed, against the child, the offense of |
involuntary servitude, involuntary sexual servitude of a |
minor, or trafficking in persons for forced labor or services, |
as provided in Section 10-9 of the Criminal Code of 1961, or |
any person who
came to know the child through an official |
capacity or position of trust,
including but not limited to |
health care professionals, educational personnel,
recreational |
supervisors, members of the clergy, and volunteers or
support |
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personnel in any setting
where children may be subject to abuse |
or neglect. |
"Temporary protective custody" means custody within a |
hospital or
other medical facility or a place previously |
designated for such custody
by the Department, subject to |
review by the Court, including a licensed
foster home, group |
home, or other institution; but such place shall not
be a jail |
or other place for the detention of criminal or juvenile |
offenders. |
"An unfounded report" means any report made under this Act |
for which
it is determined after an investigation that no |
credible evidence of
abuse or neglect exists. |
"An indicated report" means a report made under this Act if |
an
investigation determines that credible evidence of the |
alleged
abuse or neglect exists. |
"An undetermined report" means any report made under this |
Act in
which it was not possible to initiate or complete an |
investigation on
the basis of information provided to the |
Department. |
"Subject of report" means any child reported to the central |
register
of child abuse and neglect established under Section |
7.7 of this Act as an alleged victim of child abuse or neglect |
and
the parent or guardian of the alleged victim or other |
person responsible for the alleged victim's welfare who is |
named in the report or added to the report as an alleged |
perpetrator of child abuse or neglect. |
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"Perpetrator" means a person who, as a result of |
investigation, has
been determined by the Department to have |
caused child abuse or neglect. |
"Member of the clergy" means a clergyman or practitioner of |
any religious
denomination accredited by the religious body to |
which he or she belongs. |
(Source: P.A. 96-1196, eff. 1-1-11; 96-1446, eff. 8-20-10; |
96-1464, eff. 8-20-10; 97-333, eff. 8-12-11.) |
Section 10. The Adoption Act is amended by changing |
Sections 10 and 18.3a and by adding Section 18.08 as follows:
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(750 ILCS 50/10) (from Ch. 40, par. 1512)
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Sec. 10. Forms of consent and surrender; execution and
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acknowledgment thereof. |
A. The form of consent required for the
adoption of a born |
child shall be substantially as follows:
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FINAL AND IRREVOCABLE CONSENT TO ADOPTION
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I, ...., (relationship, e.g., mother, father, relative, |
guardian)
of ...., a ..male child, state:
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That such child was born on .... at ....
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That I reside at ...., County of .... and State of ....
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That I am of the age of .... years.
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That I hereby enter my appearance in this proceeding and |
waive
service of summons on me.
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That I hereby acknowledge that I have been provided with a |
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copy of the Birth Parent Rights and Responsibilities-Private |
Form before signing this Consent and that I have had time to |
read, or have had read to me, this Form. I understand that if I |
do not receive any of the rights as described in this Form, it |
shall not constitute a basis to revoke this Final and |
Irrevocable Consent. |
That I do hereby consent and agree to the adoption of such |
child.
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That I wish to and understand that by signing this consent |
I do
irrevocably and permanently give up all custody and other |
parental
rights I have to such child.
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That I understand such child will be placed for adoption |
and that I
cannot under any circumstances, after signing this |
document, change my
mind and revoke or cancel this consent or |
obtain or recover custody or
any other rights over such child. |
That I have read and understand the
above and I am signing it |
as my free and voluntary act.
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Dated (insert date).
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.........................
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If under Section 8 the consent of more than one person is |
required,
then each such person shall execute a separate |
consent.
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A-1. (1) The form of the Final and Irrevocable Consent to |
Adoption by a Specified Person or Persons: Non-DCFS Case set |
forth in this subsection A-1 is to be used by legal parents |
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only. This form is not to be used in cases in which there is a |
pending petition under Section 2-13 of the Juvenile Court Act |
of 1987. |
(2) The form of the Final and Irrevocable Consent to |
Adoption by a Specified Person or Persons in a non-DCFS case |
shall have the caption of the proceeding in which it is to be |
filed and shall be substantially as follows: |
FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY |
A SPECIFIED PERSON OR PERSONS; NON-DCFS CASE |
I, ...., (relationship, e.g., mother, father) of ...., a |
..male child, state: |
1. That such child was born on ...., at ....., City of ... |
and State of .... |
2. That I reside at ...., County of .... and State of .... |
3. That I am of the age of .... years. |
4. That I hereby enter my appearance in this proceeding and |
waive service of summons on me. |
5. That I hereby acknowledge that I have been provided a |
copy of the Birth Parent Rights and Responsibilities-Private |
Form before signing this Consent and that I have had time to |
read, or have had read to me, this Form and that I understand |
the Rights and Responsibilities described in this Form. I |
understand that if I do not receive any of my rights as |
described in said Form, it shall not constitute a basis to |
revoke this Final and Irrevocable Consent to Adoption by a |
Specified Person. |
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6. That I do hereby consent and agree to the adoption of |
such child by .... (specified persons) only. |
7. That I wish to and understand that upon signing this |
consent I do irrevocably and permanently give up all custody |
and other parental rights I have to such child if such child is |
adopted by .... (specified person or persons). I hereby |
transfer all of my rights to the custody, care and control of |
such child to ............................. (specified person |
or persons). |
8. That I understand such child will be adopted by |
....................... (specified person or persons) and that |
I cannot under any circumstances, after signing this document, |
change my mind and revoke or cancel this consent or obtain or |
recover custody or any other rights over such child if |
............................ (specified person or persons) |
adopt(s) such child; PROVIDED that each specified person has |
filed or shall file, within 60 days from the date hereof, a |
petition for the adoption of such child. |
9. That if the specified person or persons designated |
herein do not file a petition for adoption within the |
time-frame specified above, or, if said petition for adoption |
is filed within the time-frame specified above but the adoption |
petition is dismissed with prejudice or the adoption proceeding |
is otherwise concluded without an order declaring the child to |
be the adopted child of the specified person or persons, then I |
understand that I will receive written notice of such |
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circumstances within 10 business days of their occurrence. I |
understand that the notice will be directed to me using the |
contact information I have provided in this consent. I |
understand that I will have 10 business days from the date that |
the written notice is sent to me to respond, within which time |
I may request the Court to declare this consent voidable and |
return the child to me. I further understand that the Court |
will make the final decision of whether or not the child will |
be returned to me. If I do not make such request within 10 |
business days of the date of the notice, then I expressly waive |
any other notice or service of process in any legal proceeding |
for the adoption of the child. |
10. That I expressly acknowledge that nothing in this |
Consent
impairs the validity and absolute finality of this
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Consent under any circumstance other than those described in
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paragraph 9 of this Consent. |
11. That I understand that I have a remaining duty and
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obligation to keep .............. (insert name and address of |
the attorney
for the specified person or persons) informed of |
my current
address or other preferred contact information until |
this adoption has been finalized. My failure to
do so may |
result in the termination of my parental rights and
the child |
being placed for adoption in another home. |
12. That I do expressly waive any other notice or service |
of process in any of the legal proceedings for the adoption of |
the child as long as the adoption proceeding by the specified |
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person or persons is pending. |
13. That I have read and understand the above and I am |
signing it as my free and voluntary act. |
14. That I acknowledge that this consent is valid even if |
the specified person or persons separate or divorce or one of |
the specified persons dies prior to the entry of the final |
judgment for adoption. |
Dated (insert date). |
............................................. |
Signature of parent. |
............................................. |
Address of parent. |
............................................. |
Phone number(s) of parent. |
............................................. |
Personal email(s) of parent. |
............................................. |
(3) The form of the certificate of acknowledgement for a |
Final and Irrevocable Consent for Adoption by a Specified |
Person or Persons: Non-DCFS Case shall be substantially as |
follows: |
STATE OF ..............)
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) SS.
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COUNTY OF .............) |
I, .................... (Name of Judge or other person), |
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..................... (official title, name, and address), |
certify that ............., personally known to me to be the |
same person whose name is subscribed to the foregoing Final and |
Irrevocable Consent for Adoption by a Specified Person or |
Persons; non-DCFS case, appeared before me this day in person |
and acknowledged that (she)(he) signed and delivered the |
consent as (her)(his) free and voluntary act, for the specified |
purpose. I am further satisfied that, before signing this |
Consent, ........ has read, or has had read to him or her, the |
Birth Parent Rights and Responsibilities-Private Form. |
A-2. Birth Parent Rights and Responsibilities-Private |
Form. The Birth Parent Rights and Responsibilities-Private |
Form must be read by, or have been read to, any person |
executing a Final and Irrevocable Consent to Adoption under |
subsection A, a Final and Irrevocable Consent to Adoption by a |
Specified Person or Persons: Non-DCFS Case under subsection |
A-1, or a Consent to Adoption of Unborn Child under subsection |
B prior to the execution of said Consent. The form of the Birth |
Parent Rights and Responsibilities-Private Form shall be |
substantially as follows: |
Birth Parent Rights and Responsibilities-Private Form |
As a birth parent in the State of Illinois, you have the |
right: |
1. To have your own attorney represent you. The prospective |
adoptive parents may agree to pay for the cost of your attorney |
in a manner consistent with Illinois law, but they are not |
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required to do so. |
2. To be treated with dignity and respect at all times and |
to make decisions free from coercion and pressure. |
3. To receive counseling before and after signing a Final |
and Irrevocable Consent to Adoption ("Consent"), a Final and |
Irrevocable Consent to Adoption by a Specified Person or |
Persons: Non-DCFS Case ("Specified Consent"), or a Consent to |
Adoption of Unborn Child ("Unborn Consent"). The prospective |
adoptive parents may agree to pay for the cost of counseling in |
a manner consistent with Illinois law, but they are not |
required to do so. |
4. To ask to be involved in choosing your child's |
prospective adoptive parents and to ask to meet them. |
5. To ask your child's prospective adoptive parents any |
questions that pertain to your decision to place your child |
with them. |
6. To see your child before signing a Consent or Specified |
Consent. |
7. To request contact with your child and/or the child's |
prospective adoptive parents, with the understanding that any |
promises regarding contact with your child or receipt of |
information about the child after signing a Consent, Specified |
Consent, or Unborn Consent cannot be enforced under Illinois |
law. |
8. To receive copies of all documents that you sign and |
have those documents provided to you in your preferred |
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language. |
9. To request that your identifying information remain |
confidential, unless required otherwise by Illinois law or |
court order, and to register with the Illinois Adoption |
Registry and Medical Information Exchange. |
10. To work with an adoption agency or attorney of your |
choice, or change said agency or attorney, provided you |
promptly inform all of the parties currently involved. |
11. To receive, upon request, a written list of any |
promised support, financial or otherwise, from your attorney or |
the attorney for your child's prospective adoptive parents. |
12. To delay signing a Consent, Specified Consent, or |
Unborn Consent if you are not ready to do so. |
13. To decline to sign a Consent, Specified Consent, or |
Unborn Consent even if you have received financial support from |
the prospective adoptive parents. |
If you do not receive any of the rights described in this |
Form, it shall not be a basis to revoke a Consent, Specified |
Consent, or Unborn Consent. |
As a Birth Parent in the State of Illinois, you have the |
responsibility: |
1. To carefully consider your reasons for choosing |
adoption. |
2. To voluntarily provide all known medical, background, |
and family information about yourself and your immediate family |
to your child's prospective adoptive parents or their attorney. |
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For the health of your child, you are strongly encouraged, but |
not required, to provide all known medical, background, and |
family history information about yourself and your family to |
your child's prospective adoptive parents or their attorney. |
3. (Birth mothers only) To accurately complete an Affidavit |
of Identification, which identifies the father of the child |
when known, with the understanding that a birth mother has a |
right to decline to identify the birth father. |
4. To not accept financial support or reimbursement of |
pregnancy related expenses simultaneously from more than one |
source. |
B. The form of consent required for the adoption of an |
unborn child
shall be substantially as follows:
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CONSENT TO ADOPTION OF UNBORN CHILD
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I, ...., state:
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That I am the father of a child expected to be born on or |
about ....
to .... (name of mother).
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That I reside at .... County of ...., and State of .....
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That I am of the age of .... years.
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That I hereby enter my appearance in such adoption |
proceeding and
waive service of summons on me.
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That I hereby acknowledge that I have been provided with a |
copy of the Birth Parent Rights and Responsibilities-Private |
Form before signing this Consent, and that I have had time to |
read, or have had read to me, this Form. I understand that if I |
do not receive any of the rights as described in this Form, it |
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shall not constitute a basis to revoke this Consent to Adoption |
of Unborn Child. |
That I do hereby consent and agree to the adoption of such |
child, and
that I have not previously executed a consent or |
surrender with respect
to such child.
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That I wish to and do understand that by signing this |
consent I do
irrevocably and permanently give up all custody |
and other parental
rights I have to such child, except that I |
have the right to revoke this
consent by giving written notice |
of my revocation not later than 72
hours after the birth of the |
child.
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That I understand such child will be placed for adoption |
and that,
except as hereinabove provided, I cannot under any |
circumstances, after
signing this document, change my mind and |
revoke or cancel this consent
or obtain or recover custody or |
any other rights over such child.
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That I have read and understand the above and I am signing |
it as my
free and voluntary act.
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Dated (insert date).
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........................
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B-5. (1) The parent of a child may execute a consent to |
standby
adoption by a specified person or persons. A consent |
under this subsection B-5
shall be acknowledged by a parent |
pursuant to subsection H and subsection K of
this Section.
The |
form of consent required for the standby adoption of a born |
child
effective at a future date when the consenting
parent of |
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the child dies or
requests that a final judgment of adoption be |
entered shall be substantially as
follows:
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FINAL AND IRREVOCABLE CONSENT
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TO STANDBY ADOPTION
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I, ..., (relationship, e.g. mother or father)
of ...., a |
..male child, state:
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That the child was born on .... at .....
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That I reside at ...., County of ...., and State of .....
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That I am of the age of .... years.
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That I hereby enter my appearance in this proceeding and |
waive service of
summons on me in this action only.
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That I do hereby consent and
agree to the standby adoption |
of the child, and that I have not previously
executed a consent |
or surrender with respect to the child.
|
That I wish to and understand that by signing this consent |
I do irrevocably
and permanently give up all custody and other |
parental rights I have to the
child, effective upon
(my death) |
(the child's other parent's death) or upon (my) (the other
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parent's) request for the entry of a final judgment for |
adoption if .....
(specified person or persons) adopt my child.
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That I understand that until (I die) (the child's other |
parent dies), I
retain all legal rights and obligations |
concerning the child, but at that time,
I irrevocably give all |
custody and other parental rights to .... (specified
person or |
persons).
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I understand my child will be adopted by ....... (specified |
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person or
persons) only and that I cannot, under any |
circumstances, after signing this
document, change my mind and |
revoke or cancel this consent or obtain or recover
custody or |
any other rights over my child if ..... (specified person or
|
persons) adopt my child.
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I understand that this consent to standby adoption is valid |
only if the
petition for standby adoption is filed and that if |
....... (specified person or
persons), for any reason, cannot |
or will not file a petition for standby
adoption or if his, |
her, or their petition for standby adoption is denied, then
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this consent is void. I have the right to notice of any other |
proceeding that
could affect my parental rights.
|
That I have read and understand the above and I am signing |
it as my free and
voluntary act.
|
Dated (insert date).
|
....................
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If under Section 8 the consent of more than one person is |
required, then each
such
person shall execute a separate |
consent. A separate consent shall be executed
for each
child.
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(2) If the parent consents to a standby adoption by 2 |
specified persons,
then the form shall contain 2 additional |
paragraphs in substantially the
following form:
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If .... (specified persons) obtain a judgment of
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dissolution of
marriage before the judgment for adoption is |
entered, then .....
(specified person) shall adopt my child. I |
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understand that I cannot change my
mind and revoke this consent |
or obtain or recover custody of my child if .....
(specified |
persons) obtain a judgment of dissolution of marriage and .....
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(specified person) adopts my child. I understand that I cannot |
change my
mind and revoke this consent if ...... (specified |
persons) obtain a
judgment of dissolution of marriage before |
the adoption is final. I
understand that this consent to |
adoption has no effect on who will get custody
of my child if |
..... (specified persons) obtain a judgment of dissolution
of |
marriage after the adoption is final. I understand that if |
either .....
(specified persons) dies before the petition to |
adopt my child is granted, then
the surviving person may adopt |
my child. I understand that I cannot change my
mind and revoke |
this consent or obtain or recover custody of my child if the
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surviving person adopts my child.
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A consent to standby adoption by specified persons on this |
form shall have no
effect on a court's determination of custody |
or visitation under the Illinois
Marriage and Dissolution
of |
Marriage Act if the marriage of the specified persons is |
dissolved before
the adoption is final.
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(3) The form of the certificate of acknowledgement for a |
Final and
Irrevocable Consent for Standby Adoption shall be |
substantially as follows:
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STATE OF .....)
|
) SS.
|
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COUNTY OF ....)
|
I, ....... (name of Judge or other person) ..... (official |
title,
name, and address), certify that ......., personally |
known to me to be
the same person whose name is subscribed to |
the foregoing Final and Irrevocable
Consent to Standby |
Adoption, appeared before me this day in person and
|
acknowledged that (she) (he) signed and
delivered the consent |
as (her) (his) free and voluntary act, for the specified
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purpose.
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I have fully explained that this consent to adoption is |
valid only if the
petition to adopt is filed, and that if the |
specified person or persons, for
any reason, cannot or will not |
adopt the child or if the adoption petition is
denied, then |
this consent will be void. I have fully explained that if the
|
specified person or persons adopt the child, by signing this |
consent (she) (he)
is irrevocably and permanently |
relinquishing all parental rights to the child,
and (she) (he) |
has stated that such is (her) (his) intention and desire.
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Dated (insert date).
|
Signature ..............................
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(4) If a consent to standby adoption is executed in this |
form,
the consent shall be valid only if the specified
person |
or persons adopt the child. The consent shall be void if:
|
(a) the specified person or persons do not file a petition |
for standby
adoption of the child; or
|
|
(b) a court denies the standby adoption petition.
|
The parent shall not need to take further action to revoke |
the consent if the
standby adoption by the specified person or |
persons does not occur,
notwithstanding the provisions of |
Section 11 of this Act.
|
C. The form of surrender to any agency given by a parent of |
a born
child who is to be subsequently placed for adoption |
shall be
substantially as follows and shall contain such other |
facts and
statements as the particular agency shall require.
|
FINAL AND IRREVOCABLE SURRENDER
|
FOR PURPOSES OF ADOPTION
|
I, .... (relationship, e.g., mother, father, relative, |
guardian) of
...., a ..male child, state:
|
That such child was born on ...., at .....
|
That I reside at ...., County of ...., and State of .....
|
That I am of the age of .... years.
|
That I do hereby surrender and entrust the entire custody |
and control
of such child to the .... (the "Agency"), a |
(public) (licensed) child
welfare agency with its principal |
office in the City of ...., County of
.... and State of ...., |
for the purpose of enabling it to care for and
supervise the |
care of such child, to place such child for adoption and
to |
consent to the legal adoption of such child.
|
That I hereby grant to the Agency full power and authority |
to place
such child with any person or persons it may in its |
sole discretion
select to become the adopting parent or parents |
|
and to consent to the
legal adoption of such child by such |
person or persons; and to take any
and all measures which, in |
the judgment of the Agency, may be for the
best interests of |
such child, including authorizing medical, surgical
and dental |
care and treatment including inoculation and anaesthesia for
|
such child.
|
That I wish to and understand that by signing this |
surrender I do
irrevocably and permanently give up all custody |
and other parental
rights I have to such child.
|
That I understand I cannot under any circumstances, after |
signing
this surrender, change my mind and revoke or cancel |
this surrender or
obtain or recover custody or any other rights |
over such child.
|
That I have read and understand the above and I am signing |
it as my
free and voluntary act.
|
Dated (insert date).
|
........................
|
C-5. The form of a Final and Irrevocable Designated |
Surrender for Purposes of Adoption to any agency given by a |
parent of a born child who is to be subsequently placed for |
adoption is to be used by legal parents only. The form shall be |
substantially as follows and shall contain such other facts and |
statements as the particular agency shall require: |
FINAL AND IRREVOCABLE DESIGNATED SURRENDER |
FOR PURPOSES OF ADOPTION |
I, .... (relationship, e.g., mother, father, relative, |
|
guardian) of ...., a ..male child, state: |
1. That such child was born on ...., at ..... |
2. That I reside at ...., County of ...., and State of |
..... |
3. That I am of the age of .... years. |
4. That I do hereby surrender and entrust the entire |
custody and control of such child to the .... (the "Agency"), a |
(public) (licensed) child welfare agency with its principal |
office in the City of ...., County of .... and State of ...., |
for the purpose of enabling it to care for and supervise the |
care of such child, to place such child for adoption with |
............................. (specified person or persons) |
and to consent to the legal adoption of such child and to take |
any and all measures which, in the judgment of the Agency, may |
be for the best interests of such child, including authorizing |
medical, surgical and dental care and treatment including |
inoculation and anesthesia for such child. |
5. That I wish to and understand that by signing this |
surrender I do irrevocably and permanently give up all custody |
and other parental rights I have to such child. |
6. That if the petition for adoption is not filed by the
|
specified person or persons designated herein or, if the
|
petition for adoption is filed but the adoption petition is
|
dismissed with prejudice or the adoption proceeding is
|
otherwise concluded without an order declaring the child to be
|
the adopted child of each specified person, then I understand |
|
that the Agency will provide notice to me within 10 business |
days and that such notice will be directed to me using the |
contact information I have provided to the Agency. I understand |
that I will have 10 business days from the date that the Agency |
sends me its notice to respond, within which time I may choose |
to designate other adoptive parent(s). However, I acknowledge |
that
the Agency has full power and authority to place the child |
for adoption with
any person or persons it may in its sole |
discretion select to
become the adopting parent or parents and |
to consent to the
legal adoption of the child by such person or |
persons. |
7. That I acknowledge that this surrender is valid even if |
the specified persons separate or divorce or one of the |
specified persons dies prior to the entry of the final judgment |
for adoption. |
8. That I expressly acknowledge that the above paragraphs 6 |
and 7 do not impair the validity and absolute finality of this |
surrender under any circumstance. |
9. That I understand that I have a remaining obligation to |
keep the Agency informed of my current contact information |
until the adoption of the child has been finalized if I wish to |
be notified in the event the adoption by the specified |
person(s) cannot proceed. |
10. That I understand I cannot under any circumstances, |
after signing this surrender, change my mind and revoke or |
cancel this surrender or obtain or recover custody or any other |
|
rights over such child. |
11. That I have read and understand the above and I am |
signing it as my free and voluntary act. |
Dated (insert date). |
.............................. |
D. The form of surrender to an agency given by a parent of |
an unborn
child who is to be subsequently placed for adoption |
shall be
substantially as follows and shall contain such other |
facts and
statements as the particular agency shall require.
|
SURRENDER OF UNBORN CHILD FOR
|
PURPOSES OF ADOPTION
|
I, .... (father), state:
|
That I am the father of a child expected to be born on or |
about ....
to .... (name of mother).
|
That I reside at ...., County of ...., and State of .....
|
That I am of the age of .... years.
|
That I do hereby surrender and entrust the entire custody |
and control
of such child to the .... (the "Agency"), a |
(public) (licensed) child
welfare agency with its principal |
office in the City of ...., County of
.... and State of ...., |
for the purpose of enabling it to care for and
supervise the |
care of such child, to place such child for adoption and
to |
consent to the legal adoption of such child, and that I have |
not
previously executed a consent or surrender with respect to |
such child.
|
That I hereby grant to the Agency full power and authority |
|
to place
such child with any person or persons it may in its |
sole discretion
select to become the adopting parent or parents |
and to consent to the
legal adoption of such child by such |
person or persons; and to take any
and all measures which, in |
the judgment of the Agency, may be for the
best interests of |
such child, including authorizing medical, surgical
and dental |
care and treatment, including inoculation and anaesthesia for
|
such child.
|
That I wish to and understand that by signing this |
surrender I do
irrevocably and permanently give up all custody |
and other parental
rights I have to such child.
|
That I understand I cannot under any circumstances, after |
signing
this surrender, change my mind and revoke or cancel |
this surrender or
obtain or recover custody or any other rights |
over such child, except
that I have the right to revoke this |
surrender by giving written notice
of my revocation not later |
than 72 hours after the birth of such child.
|
That I have read and understand the above and I am signing |
it as my
free and voluntary act.
|
Dated (insert date).
|
........................
|
E. The form of consent required from the parents for the |
adoption of
an adult, when such adult elects to obtain such |
consent, shall be
substantially as follows:
|
CONSENT
|
I, ...., (father) (mother) of ...., an adult, state:
|
|
That I reside at ...., County of .... and State of .....
|
That I do hereby consent and agree to the adoption of such |
adult by
.... and .....
|
Dated (insert date).
|
.........................
|
F. The form of consent required for the adoption of a child |
of the
age of 14 years or upwards, or of an adult, to be given |
by such person,
shall be substantially as follows:
|
CONSENT
|
I, ...., state:
|
That I reside at ...., County of .... and State of ..... |
That I am
of the age of .... years. That I consent and agree to |
my adoption by
.... and .....
|
Dated (insert date).
|
........................
|
G. The form of consent given by an agency to the adoption |
by
specified persons of a child previously surrendered to it |
shall set
forth that the agency has the authority to execute |
such consent. The
form of consent given by a guardian of the |
person of a child sought to
be adopted, appointed by a court of |
competent jurisdiction, shall set
forth the facts of such |
appointment and the authority of the guardian to
execute such |
consent.
|
H. A consent (other than that given by an agency, or |
guardian of the
person of the child sought to be adopted who |
was appointed by a court of
competent jurisdiction) shall be |
|
acknowledged by a parent before a judge of a court of competent |
jurisdiction or, except as otherwise provided in
this Act, |
before a representative of an agency, or before a person, other |
than the attorney for the prospective adoptive parent or |
parents, designated by a court of competent
jurisdiction.
|
I. A surrender, or any other document equivalent to a |
surrender, by
which a child is surrendered to an agency shall |
be acknowledged by the
person signing such surrender, or other |
document, before a judge of a court of competent jurisdiction, |
or, except as otherwise provided in this Act, before a |
representative of an agency, or before a person designated by a |
court
of competent jurisdiction.
|
J. The form of the certificate of acknowledgment for a |
consent, a
surrender, or any other document equivalent to a |
surrender, shall be
substantially as follows:
|
STATE OF ....)
|
) SS.
|
COUNTY OF ...)
|
I, .... (Name of judge or other person), .... (official |
title, name and
location of court or status or position of |
other person),
certify that ...., personally known to me to be |
the same person whose
name is subscribed to the foregoing |
(consent) (surrender), appeared
before me this day in person |
and acknowledged that (she) (he) signed and
delivered such |
(consent) (surrender) as (her) (his) free and voluntary
act, |
for the specified purpose.
|
|
I have fully explained that by signing such (consent) |
(surrender)
(she) (he) is irrevocably relinquishing all |
parental rights to such
child or adult and (she) (he) has |
stated that such is (her) (his)
intention and desire. (Add if |
Consent only) I am further satisfied that, before signing this |
Consent, ........ has read, or has had read to him or her, the |
Birth Parent Rights and Responsibilities-Private Form.
|
Dated (insert date).
|
Signature ...............
|
K. When the execution of a consent or a surrender is |
acknowledged
before someone other than a judge,
such other |
person shall have his or her signature on the certificate
|
acknowledged before a notary public, in form substantially as |
follows:
|
STATE OF ....)
|
) SS.
|
COUNTY OF ...)
|
I, a Notary Public, in and for the County of ......, in the |
State of
......, certify that ...., personally known to me to |
be the
same person whose name is subscribed to the foregoing |
certificate of
acknowledgment, appeared before me in person and |
acknowledged that (she)
(he) signed such certificate as (her) |
(his) free and voluntary act and
that the statements made in |
the certificate are true.
|
Dated (insert date).
|
Signature ...................... Notary Public
|
|
(official seal)
|
There shall be attached a certificate of magistracy, or |
other
comparable proof of office of the notary public |
satisfactory to the
court, to a consent signed and acknowledged |
in another state.
|
L. A surrender or consent executed and acknowledged outside |
of this
State, either in accordance with the law of this State |
or in accordance
with the law of the place where executed, is |
valid.
|
M. Where a consent or a surrender is signed in a foreign |
country,
the execution of such consent shall be acknowledged or |
affirmed in a
manner conformable to the law and procedure of |
such country.
|
N. If the person signing a consent or surrender is in the |
military
service of the United States, the execution of such |
consent or surrender
may be acknowledged before a commissioned |
officer and the signature of
such officer on such certificate |
shall be verified or acknowledged
before a notary public or by |
such other procedure as is then in effect
for such division or |
branch of the armed forces.
|
O. (1) The parent or parents of a child in whose interests |
a petition
under Section 2-13 of the Juvenile Court Act of 1987 |
is pending may, with the
approval of the designated |
representative of the Department of Children and
Family |
Services ("Department" or "DCFS") , execute a consent to |
|
adoption by a specified person or
persons:
|
(a) in whose physical custody the child has resided for |
at least 6
months;
or
|
(b) in whose physical custody at least one sibling of |
the child who is the
subject of this consent has resided |
for at least 6 months, and
the child who is
the subject of |
this consent is currently residing in this foster home; or
|
(c) in whose physical custody a child under one year of |
age has resided
for at least 3 months.
|
The court may waive the time frames in subdivisions (a), (b), |
and (c) for good cause shown if the court finds it to be in the |
child's best interests. |
A consent under this subsection O shall be acknowledged by a |
parent pursuant to
subsection H and subsection K of this |
Section.
|
(2) The final and irrevocable consent to adoption by a |
specified person or persons in a Department of Children and |
Family Services (DCFS) case consent to adoption by a specified |
person or persons shall have the
caption of the proceeding in |
which it is to be filed and shall be substantially
as follows:
|
FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY
|
A SPECIFIED PERSON OR PERSONS: DCFS CASE
|
I, ......................................, the |
.................. (mother or
father) of a ....male child, |
state:
|
1. My child ............................ (name of |
|
child) was born on
(insert date) at .................... |
Hospital in the municipality of ........., in
|
................ County, State of ...............
|
2. I reside at ......................, County of |
............. and
State of .............. |
Mail may also be sent to me at this address |
............................, in care of ................. |
My home telephone number is .......................... |
My cell telephone number is .......................... |
My e-mail address is .................................
|
3. I, ..........................., am .... years old.
|
4. I enter my appearance in this action for my child to |
be adopted to adopt my child by the
person or persons |
specified herein by me and waive service of
summons on me |
in this action only.
|
5. I hereby acknowledge that I have been provided a |
copy of the Birth Parent Rights and Responsibilities for |
DCFS Cases before signing this Consent and that I have had |
time to read this form or have it read to me and that I |
understand the rights and responsibilities described in |
this form. I understand that if I do not receive any of my |
rights as described in the form, it shall not constitute a |
basis to revoke this Final and Irrevocable Consent to |
Adoption by a Specified Person or Persons. |
6. I do hereby consent and agree to the adoption of |
such child by .......... (specified person or persons) |
|
only. |
7. I wish to sign this consent and I understand that by |
signing this consent I irrevocably and permanently give up |
all my parental rights I have to my child. |
8. I understand that this consent allows my child to be |
adopted by .......... only and that I cannot under any |
circumstances after signing this document change my mind |
and revoke or cancel this consent. |
9. I understand that this consent will be void if: |
(a) the Department places my child with someone |
other than the specified person or persons; or |
(b) a court denies the adoption petition for the |
specified person or persons to adopt my child; or |
(c) the DCFS Guardianship Administrator refuses to |
consent to my child's adoption by the specified person |
or persons on the basis that the adoption is not in my |
child's best interests. |
I understand that if this consent is void I have |
parental rights to my child, subject to any applicable |
court orders including those entered under Article II of |
the Juvenile Court Act of 1987, unless and until I sign a |
new consent or surrender or my parental rights are |
involuntarily terminated. I understand that if this |
consent is void, my child may be adopted by someone other |
than the specified person or persons only if I sign a new |
consent or surrender, or my parental rights are |
|
involuntarily terminated. I understand that if this |
consent is void, the Department will notify me within 30 |
days using the addresses and telephone numbers I provided |
in paragraph 2 of this form. I understand that if I receive |
such a notice, it is very important that I contact the |
Department immediately, and preferably within 30 days, to |
have input into the plan for my child's future. |
10. I understand that if a petition for adoption of my |
child is filed by someone other than the specified person |
or persons, the Department will notify me within 14 days |
after the Department becomes aware of the petition. The |
fact that someone other than the specified person or |
persons files a petition to adopt my child does not make |
this consent void. |
11. If a person other than the specified person or |
persons files a petition to adopt my child or if the |
consent is void under paragraph 9, the Department will send |
written notice to me using the mailing address and email |
address provided by me in paragraph 2 of this form. The |
Department will also contact me using the telephone numbers |
I provided in paragraph 2 of this form. It is very |
important that I let the Department know if any of my |
contact information changes. If I do not let the Department |
know if any of my contact information changes, I understand |
that I may not receive notification from the Department if |
this consent is void or if someone other than the specified |
|
person or persons files a petition to adopt my child. If |
any of my contact information changes, I should immediately |
notify: |
Caseworker's name and telephone number: |
............................................................; |
Agency name, address, zip code, and telephone number: |
............................................................; |
Supervisor's name and telephone number: |
............................................................; |
DCFS Advocacy Office for Children and Families: |
800-232-3798. |
12. I expressly acknowledge that paragraph 9 (and |
paragraphs 8a and 8b, if applicable) do not impair the |
validity and finality of this consent under any |
circumstances.
|
I consent to the adoption of my child by
|
.............................
(specified person or |
persons) only.
|
I wish to sign this consent and I understand that by |
signing this
consent I irrevocably and permanently give up |
all parental rights I have to my
child if my child is |
adopted by ............................. (specified person
|
or persons).
|
I understand my child will be adopted by |
.............................
(specified person or |
persons) only and that I cannot under any circumstances,
|
|
after signing this document, change my mind and revoke or |
cancel this consent
or obtain or recover custody or any |
other rights over my child if
............................ |
(specified person or persons) adopt my child.
|
I understand that this consent to adoption is valid |
only if the
petition to adopt is filed within one year from |
the date that I sign it and
that if ....................... |
(specified person or persons), for any reason,
cannot or |
will not file a petition to adopt my child within that one |
year
period or if their adoption petition is denied, then |
this consent will be
voidable after one year upon the |
timely filing of my motion. If I file this
motion before |
the filing of the petition for adoption, I understand that |
the
court shall revoke this specific consent.
I have the |
right to notice of any other proceeding that could affect |
my
parental rights, except for the proceeding for |
............. (specified person
or persons) to adopt my |
child.
|
13. I have read and understand the above and I am |
signing it as my free
and voluntary act.
|
Dated (insert date).
|
.............................................
|
Signature of parent
|
(3) If the parent consents to an adoption by 2 specified |
persons, then the
form shall contain 2 additional paragraphs in |
substantially the following form:
|
|
8a. If ............... (specified persons) get a |
divorce
or are granted a dissolution of a civil union |
before the petition to adopt my child is granted, this |
consent is valid for ........... (specified person) to |
adopt my child. I understand that I cannot change my mind |
or revoke this consent or recover custody of my child on |
the basis that the specified persons divorce or are granted |
a dissolution of a civil union. then ..........
(specified |
person) shall adopt my child. I understand that I
cannot |
change my mind and revoke this consent or obtain or
recover |
custody over my child if ............. (specified persons)
|
divorce and ............. (specified person) adopts my
|
child. I understand that I cannot change my mind and revoke
|
this consent or obtain or recover custody over my child if
|
................. (specified persons) divorce after the
|
adoption is final. I understand that this consent to |
adoption
has no effect on who will get custody of my child |
if they
divorce after the adoption is final.
|
8b. I understand that if either ...............
|
(specified persons) dies before the petition to adopt
my |
child is granted, this consent remains valid for the |
surviving person to adopt my child. I understand that I |
cannot change my mind or revoke this consent or recover |
custody of my child on the basis that one of the specified |
persons dies. then the surviving person can adopt my child. |
I
understand that I cannot change my mind and revoke this |
|
consent
or obtain or recover custody over my child if the |
surviving
person adopts my child.
|
A consent to adoption by specified persons on this form |
shall
have no effect on a court's determination of custody or |
visitation
under the Illinois Marriage and Dissolution of |
Marriage Act if the
marriage of the
specified persons is |
dissolved after the adoption is final.
|
(4) The form of the certificate of acknowledgement for a |
Final and
Irrevocable Consent for Adoption by a Specified |
Person or Persons: DCFS Case shall be
substantially as follows:
|
STATE OF ..............)
|
) SS.
|
COUNTY OF .............)
|
I, .................... (Name of Judge or other person),
|
..................... (official title, name, and address),
|
certify that ............., personally known to me to be the |
same person whose
name is subscribed to the foregoing Final and |
Irrevocable Consent for Adoption
by a Specified Person or |
Persons : DCFS Case , appeared before me this day
in person and |
acknowledged that (she)(he) signed and delivered the consent as
|
(her)(his) free and voluntary act, for the specified purpose.
|
I have fully explained that this consent to adoption is |
valid only if the
petition to adopt is filed within one year |
from the date that it is signed, and
that if the specified |
|
person or persons, for any reason, cannot or will not
adopt the |
child or if the adoption petition is denied, then this consent |
will
be voidable after one year upon the timely filing of a |
motion by the parent
to revoke the consent. I explained that if |
this motion is filed before the
filing of the petition for |
adoption, the court shall revoke this specific
consent. I have |
fully explained that if the specified person or
persons adopt
|
the child, by signing this consent this parent is irrevocably
|
and permanently
relinquishing all parental rights to the child |
so that the child may be adopted by a specified person or |
persons , and this parent has stated that
such is (her)(his) |
intention and desire. I have fully explained that this consent |
is void only if:
|
(a) the placement is disrupted and the child is moved |
to a different placement; or |
(b) a court denies the petition for adoption; or |
(c) the Department of Children and Family Services |
Guardianship Administrator refuses to consent to the |
child's adoption by a specified person or persons on the |
basis that the adoption is not in the child's best |
interests. |
Dated (insert date).
|
...............................
|
Signature
|
(5) If a consent to adoption by a specified person or |
persons is executed in
this form, the following provisions |
|
shall apply. The consent shall be valid
only for the if that |
specified person or persons to adopt the child. The consent |
shall be void
voidable after one year if:
|
(a) the placement disrupts and the child is moved to |
another placement the specified person or persons do not |
file a petition to adopt the
child within one year after |
the consent is signed and the parent files a
timely motion |
to revoke this consent. If this motion is filed before the
|
filing of the petition for adoption the court shall revoke |
this consent ; or
|
(b) a court denies the petition for adoption a court |
denies the adoption petition ; or
|
(c) the Department of Children and Family Services |
Guardianship
Administrator refuses to consent to the |
child's adoption by the specified person or persons on the |
basis that the adoption is not in the child's best |
interests determines that the specified person or persons |
will not or
cannot complete the adoption, or in the best |
interests of the child should not
adopt the child .
|
If the consent is void under this Section, the parent shall |
not need to take further action to revoke the consent. No |
proceeding for termination of parental rights shall be brought |
unless the parent who executed the consent to adoption by a |
specified person or persons has been notified of the |
proceedings pursuant to Section 7 of this Act or subsection (4) |
of Section 2-13 of the Juvenile Court Act of 1987. Within 30 |
|
days of the consent becoming void, the Department of Children |
and
Family Services Guardianship Administrator shall make good |
faith attempts to
notify the parent in writing and shall give |
written notice to the court and all
additional parties in |
writing that the adoption has not occurred or will not
occur |
and that the consent is void. If the adoption by a specified |
person or
persons does not occur, no proceeding for termination |
of parental rights shall
be brought unless the biological |
parent who executed the consent to adoption by
a specified |
person or persons has been notified of the proceeding pursuant |
to
Section 7 of this Act or subsection (4) of Section 2-13 of |
the Juvenile Court
Act of 1987. The parent shall not need to |
take further action to revoke the
consent if the specified |
adoption does not occur, notwithstanding the
provisions of |
Section 11 of this Act.
|
(6) The Department of Children and Family Services is |
authorized
to promulgate rules necessary to implement this |
subsection O.
|
(7) (Blank). The Department shall collect and maintain data |
concerning the efficacy
of specific consents. This data shall |
include the number of specific consents
executed and their |
outcomes, including but not limited to the number of
children |
adopted pursuant to the consents, the number of children for |
whom
adoptions are not completed, and the reason or reasons why |
the adoptions are
not completed.
|
(8) The Department of Children and Family Services shall |
|
promulgate a rule and procedures regarding Consents to Adoption |
by a Specified Person or Persons in DCFS cases. The rule and |
procedures shall provide for the development of the Birth |
Parent Rights and Responsibilities Form for DCFS
Cases. |
(9) A consent to adoption by specified persons on this
|
consent form shall have no effect on a court's determination of
|
custody or visitation under the Illinois Marriage and
|
Dissolution of Marriage Act or the Illinois Religious Freedom
|
Protection and Civil Union Act if the marriage or civil union |
of the
specified persons is dissolved after the adoption is |
final. |
P. If the person signing a consent is incarcerated or |
detained in a correctional facility, prison, jail, detention |
center, or other comparable institution, either in this State |
or any other jurisdiction, the execution of such consent may be |
acknowledged before social service personnel of such |
institution, or before a person designated by a court of |
competent jurisdiction. |
Q. A consent may be acknowledged telephonically, via |
audiovisual connection, or other electronic means, provided |
that a court of competent jurisdiction has entered an order |
approving the execution of the consent in such manner and has |
designated an individual to be physically present with the |
parent executing such consent in order to verify the identity |
of the parent. |
R. An agency whose representative is acknowledging a |
|
consent pursuant to this Section shall be a public child |
welfare agency, or a child welfare agency, or a child placing |
agency that is authorized or licensed in the State or |
jurisdiction in which the consent is signed. |
S. The form of waiver by a putative or legal father of a |
born or unborn child shall be substantially as follows: |
FINAL AND IRREVOCABLE |
WAIVER OF PARENTAL RIGHTS OF PUTATIVE OR LEGAL FATHER |
I, .................... , state under oath or affirm as |
follows: |
1. That the biological mother ............... has |
named me as a possible biological or
legal father of her |
minor child who was born, or is expected to be born on
|
..........., ......, in the City/Town of........., State |
of ........... |
2. That I understand that the biological mother |
............. intends to or has placed the child
for |
adoption. |
3. That I reside at ................, in the City/Town |
of...........,
State of ................ |
4. That I am ................ years of age and my date |
of birth is ..............., ............. |
5. That I (select one): |
..... am married to the biological mother. |
|
..... am not married to the biological mother and |
have not been married to the biological
mother within |
300 days before the child's birth or expected date of |
child's birth. |
..... am not currently married to the biological |
mother, but was married to the biological
mother, |
within 300 days before the child's birth or expected |
date of child's birth. |
6. That I (select one): |
..... neither admit nor deny that I am the |
biological father of the child. |
..... deny that I am the biological father of the |
child. |
7. That I hereby agree to the termination of my |
parental rights, if any, without further notice to me
of |
any proceeding for the adoption of the minor child, even if |
I have taken any action to establish
parental rights or |
take any such action in the future including registering |
with any putative father
registry. |
8. That I understand that by signing this Waiver I do |
irrevocably and permanently give up all
custody and other |
parental rights I may have to such child. |
9. That I understand that this Waiver is FINAL AND |
IRREVOCABLE and that I am permanently
barred from |
contesting any proceeding for the adoption of the child |
after I sign this Waiver. |
|
10. That I waive any further service of summons or |
other pleadings in any proceeding to terminate
parental |
rights, if any to this child, or any proceeding for |
adoption of this child. |
11. That I understand that if a final judgment or order |
of adoption for this child is not entered, then
any |
parental rights or responsibilities that I may have remain |
intact. |
12. That I have read and understand the above and that |
I am signing it as my free and voluntary act. |
Dated: ................... , .............. |
........................................... |
Signature |
OATH |
I have been duly sworn and I state under oath that I have read |
and understood this Final and Irrevocable
Waiver of Parental |
Rights of Putative or Legal Father. The facts contained in it |
are true and correct to the
best of my knowledge. I have signed |
this document as my free and voluntary act in order to |
facilitate the
adoption of the child. |
.............................. |
Signature |
|
Signed and Sworn before me on |
this ............ day |
of ..........., 20.... |
................... |
Notary Public |
(Source: P.A. 96-601, eff. 8-21-09; 96-1461, eff. 1-1-11; |
97-493, eff. 8-22-11.)
|
(750 ILCS 50/18.08 new) |
Sec. 18.08. Adoption Advisory Council. |
(a) There shall be established under the Department of |
Public Health and the Department of Children and Family |
Services the Adoption Advisory Council. The Council shall |
include: |
(1) the Director of the Department of Public Health, or |
his or her designee, who shall serve as the co-chairperson |
of the Council; |
(2) the Director of the Department of Children and |
Family Services, or his or her designee, who shall serve as |
the co-chairperson of the Council; |
(3) an attorney representing the Attorney General's |
Office appointed by the Attorney General; |
(4) a currently certified confidential intermediary |
appointed by the Director of the Department of Children and |
Family Services; |
|
(5) one representative from each of the following |
organizations appointed by the Director of the Department |
of Public Health: Adoption Advocates of America, Adoptive |
Families Today, Catholic Conference of Illinois, Chicago |
Area Families for Adoption, Chicago Bar Association, Child |
Care Association of Illinois, Children Remembered, Inc., |
Children's Home and Aid Society of Illinois, Child Welfare |
Advisory Council, The Cradle, Healing Hearts, Illinois |
Foster Parents Association, Illinois State Bar |
Association, Illinois State Medical Society, Jewish |
Children's Bureau, LDS Social Services, Lutheran Social |
Services of Illinois, Maryville Academy, Midwest Adoption |
Center, St. Mary's Services, Stars of David, and |
Truthseekers in Adoption; |
(6) 5 additional members appointed by the Director of |
the Department of Children and Family Services who shall, |
when making those appointments, consider advocates for |
adopted persons, adoptive parents, or birth parents, |
lawyers who represent clients in private adoptions, |
lawyers specializing in privacy law, and representatives |
of agencies involved in adoptions; |
(7) an attorney from the Department of Children and |
Family Services, who shall serve as an ex-officio, |
non-voting advisor to the Council; and |
(8) the person directly responsible for administering |
the confidential intermediary program, who shall serve as |
|
an ex-officio, non-voting advisor to the Council. |
(b) If any one of the named organizations in item (5) of |
subsection (a) notifies the Director of the Department of |
Public Health or the Director of the Department of Children and |
Family Services in writing that the organization does not wish |
to participate on the Adoption Advisory Council or that the |
organization is no longer functioning, the Directors may |
designate another organization that represents the same |
constituency as the named organization to replace the named |
organization on the Council. |
(c) Council members shall receive no compensation for their |
service. The Council shall meet no less often than once every 6 |
months and shall meet as the Director of the Department of |
Public Health or the Director of the Department of Children and |
Family Services deems necessary. The Council shall have only an |
advisory role to the Directors and may make recommendations to |
the pertinent Department regarding the development of rules, |
procedures, and forms that will promote the efficient and |
effective operation of (i) the Illinois Adoption Registry, (ii) |
the Office of Vital Records as it pertains to the Registry and |
to access to the non-certified copy of the original birth |
certificate, and (iii) the Confidential Intermediary Program |
in Illinois. The Council will also serve in an advisory |
capacity regarding the effective delivery of adult |
post-adoption services in Illinois, including: |
(1) advising the Department of Public Health on the |
|
development of rules, procedures, and forms utilized by the |
Illinois Adoption Registry and Medical Information |
Exchange; |
(2) making recommendations regarding the procedures, |
tools, and technology that will promote efficient and |
effective operation of the Registry; |
(3) assisting the Department of Public Health with the |
development, publication, and circulation of an |
informational pamphlet that describes the purpose, |
function, and mechanics of the Illinois Adoption Registry |
and Medical Information Exchange, including information |
about who is eligible to register and how to register; |
information about the questions and concerns that |
registrants may develop when they register or when they |
receive information from the Registry; and a list of |
services, programs, groups, and informational websites |
that are available to assist registrants with their |
questions and concerns; |
(4) collecting, compiling, and reviewing statistical |
data and empirical information concerning the procedures |
in the Registry including, but not limited to, data |
concerning the filing of Denials of Information Exchange, |
Information Exchange Authorizations, Requests for a |
Non-Certified Copy of an Original Birth Certificate, and |
Birth Parent Preference Forms; |
(5) making recommendations to the Director of the |
|
Department of Children and Family Services regarding the |
standards for certification for confidential |
intermediaries; |
(6) making recommendations to the Director of the |
Department of Children and Family Services concerning |
oversight methods used to verify that intermediaries are |
complying with the appropriate laws; |
(7) assisting the Department of Children and Family |
Services with training for confidential intermediaries, |
including training with respect to federal and State |
privacy laws; |
(8) reviewing the relationship between confidential |
intermediaries and the court system and making |
recommendations to the Director of the Department of |
Children and Family Services concerning sample orders that |
define the scope of the intermediaries' access to |
information; |
(9) considering any recent violations of policy or |
procedures by confidential intermediaries and remedial |
steps, including decertification, which might be |
recommended to the Director of the Department of Children |
and Family Services so as to prevent future violations; and |
(10) reviewing reports from the Department of Children |
and Family Services submitted by July 1 and January 1 of |
each year in order detailing the penalties assessed and |
collected, the amounts of related deposits into the DCFS |
|
Children's Services Fund, and any expenditures from such |
deposits. |
(d) Within 45 days after the effective date of this |
amendatory Act of the 97th General Assembly, both the Adoption |
Registry Advisory Council and the Confidential Intermediary |
Council shall, notwithstanding any other provision of this Act, |
turn over the Council's records to the Adoption Advisory |
Council and cease to function.
|
(750 ILCS 50/18.3a) (from Ch. 40, par. 1522.3a)
|
Sec. 18.3a. Confidential intermediary.
|
(a) General purposes.
Notwithstanding any other provision |
of
this Act, any
adopted or surrendered person 21 years of age |
or over, any adoptive parent or legal guardian
of
an adopted or |
surrendered person under the age of 21, or any birth parent of |
an adopted
or surrendered person who is 21 years of age or over |
may petition the court in any county in
the
State of Illinois |
for appointment of a confidential intermediary as provided in
|
this Section for the purpose of exchanging medical information |
with one or
more mutually consenting biological relatives, |
obtaining identifying
information about one or more mutually |
consenting biological relatives, or
arranging contact with one |
or more mutually consenting biological relatives.
|
Additionally, in cases where an adopted or surrendered person |
is deceased,
an adult child of the adopted
or surrendered |
person or his or her adoptive parents or surviving spouse may |
|
file a petition under this Section and in cases
where the birth |
parent is deceased,
an adult birth sibling of the adopted or |
surrendered person or of the deceased birth parent
may
file a |
petition under this Section for the purpose of exchanging |
medical
information with one or more mutually consenting |
biological relatives of the adopted or surrendered person,
|
obtaining identifying information about one or more mutually |
consenting
biological relatives of the adopted or surrendered |
person, or arranging contact with one or more mutually
|
consenting biological relatives of the adopted or surrendered |
person. Beginning January 1, 2006, any adopted or surrendered |
person 21 years of age or over; any adoptive parent or legal |
guardian of an adopted or surrendered person under the age of |
21; any birth parent, birth sibling, birth aunt, or birth uncle |
of an adopted or surrendered person over the age of 21; any |
surviving child, adoptive parent, or surviving spouse of a |
deceased adopted or surrendered person who wishes to petition |
the court for the appointment of a confidential intermediary |
shall be required to accompany their petition with proof of |
registration with the Illinois Adoption Registry and Medical |
Information Exchange.
|
(b) Petition. Upon petition by an adopted or surrendered
|
person 21 years of age or over (an "adult adopted or |
surrendered person"), an
adoptive parent or legal guardian of |
an adopted or surrendered person under the age of 21,
or a |
birth parent of an adopted or surrendered person who is 21 |
|
years of age or over, the
court
shall appoint a confidential |
intermediary. Upon petition by
an adult child, adoptive parent |
or surviving spouse of an adopted or surrendered person who is |
deceased, by an adult birth sibling of an adopted or |
surrendered person
whose common birth parent is deceased
and |
whose adopted or surrendered birth sibling is 21 years of age |
or over, or by an adult sibling of a birth parent who is |
deceased,
and whose surrendered child is 21 years of age or |
over, the court may appoint a confidential
intermediary if the |
court finds that the disclosure is of greater benefit than
|
nondisclosure.
The petition shall state which biological |
relative
or
relatives are being sought and shall indicate if |
the petitioner wants to do any
one or more of the following: |
exchange medical information with the
biological relative or |
relatives, obtain identifying information from the
biological |
relative or relatives, or to arrange contact with the |
biological
relative.
|
(c) Order. The order appointing the confidential |
intermediary shall allow
that
intermediary to conduct a search |
for the sought-after relative by accessing
those records |
described in subsection (g) of this Section.
|
(d) Fees and expenses. The court shall not condition the |
appointment of the
confidential intermediary on the |
petitioner's payment of the intermediary's
fees and expenses in |
advance of the commencement of the work of the
confidential |
intermediary. No However, no fee shall be charged if the |
|
petitioner is an adult adopted or surrendered person and the |
sought-after relative is a birth parent who filed or who did |
not file a Denial with the Registry prior to January 1, 2011, |
or filed a Birth Parent Preference Form on which Option E was |
selected after January 1, 2011 and more than 5 years have |
transpired since the birth parent filed the Denial of |
Information Exchange or Birth Parent Preference Form on which |
Option E was selected.
|
(e) Eligibility of intermediary. The court may appoint as |
confidential
intermediary any
person certified by the |
Department of Children and Family Services as qualified to |
serve as a confidential
intermediary.
Certification shall be |
dependent upon the
confidential intermediary completing a |
course of training including, but not
limited to, applicable |
federal and State privacy laws.
|
(f) (Blank). Confidential Intermediary Council. There |
shall be established under the
Department of Children and |
Family
Services a Confidential Intermediary Advisory Council. |
One member shall be an
attorney representing the Attorney |
General's Office appointed by the Attorney
General. One member |
shall be a currently certified confidential intermediary
|
appointed by the Director of the Department of Children and |
Family Services.
The Director shall also appoint 5 additional |
members. When making those
appointments, the Director shall |
consider advocates for adopted persons,
adoptive parents, |
birth parents, lawyers who represent clients in private
|
|
adoptions, lawyers specializing in privacy law, and |
representatives of agencies
involved in adoptions. The |
Director shall appoint one of the 7 members as
the chairperson. |
An attorney from the Department of Children and Family
Services
|
and the person directly responsible for administering the |
confidential
intermediary program shall serve as ex-officio, |
non-voting advisors to the
Council. Council members shall serve |
at the discretion of the Director and
shall receive no |
compensation other than reasonable expenses approved by the
|
Director. The Council shall meet no less than twice yearly and |
shall meet at least once yearly with the Registry Advisory |
Council, and shall make
recommendations to the Director |
regarding the development of rules, procedures,
and forms that |
will ensure efficient and effective operation of the
|
confidential intermediary process, including:
|
(1) Standards for certification for confidential |
intermediaries.
|
(2) Oversight of methods used to verify that |
intermediaries are complying
with the appropriate laws.
|
(3) Training for confidential intermediaries, |
including training with
respect to federal and State |
privacy laws.
|
(4) The relationship between confidential |
intermediaries and the court
system, including the |
development of sample orders defining the scope of the
|
intermediaries' access to information.
|
|
(5) Any recent violations of policy or procedures by |
confidential
intermediaries and remedial steps, including |
decertification, to prevent future
violations.
|
(g) Access. Subject to the limitations of subsection (i) |
of this
Section, the
confidential
intermediary shall have |
access to vital records or a comparable public entity that |
maintains vital records in another state in accordance with |
that state's laws, maintained by the Department of
Public |
Health and its local designees for the maintenance of vital |
records or a comparable public entity that maintains vital |
records in another state in accordance with that state's laws |
and
all records of the court or any adoption agency,
public
or |
private, as limited in this Section, which relate to the |
adoption or the identity and location of an
adopted or |
surrendered person, of an adult child or surviving spouse of a |
deceased adopted or surrendered person, or of a birth
parent, |
birth sibling, or the sibling of a deceased birth parent. The
|
confidential intermediary shall not have access to any personal |
health
information protected by the Standards for Privacy of |
Individually
Identifiable Health Information adopted by the |
U.S. Department of Health and
Human Services under the Health |
Insurance Portability and Accountability Act of
1996 unless the |
confidential intermediary has obtained written consent from |
the
person whose information is being sought by an adult |
adopted or surrendered person or, if that person is a minor |
child,
that person's parent or guardian. Confidential
|
|
intermediaries shall be authorized to inspect confidential |
relinquishment and
adoption records. The confidential |
intermediary shall not be authorized to
access medical
records, |
financial records, credit records, banking records, home |
studies,
attorney file records, or other personal records.
In |
cases where a birth parent is being sought, an adoption agency |
shall inform
the confidential intermediary of any statement |
filed pursuant to Section 18.3, hereinafter referred to as "the |
18.3 statement",
indicating a desire of the surrendering birth |
parent to have identifying
information shared or to not have |
identifying information shared. If there was
a clear statement |
of intent by the sought-after birth parent not to have
|
identifying information shared, the confidential intermediary |
shall discontinue
the search and inform the petitioning party |
of the sought-after relative's
intent unless the birth parent |
filed the 18.3 statement prior to the effective date of this |
amendatory Act of the 96th General Assembly and more than 5 |
years have elapsed since the filing of the 18.3 statement. If |
the adult adopted or surrendered person is the subject of an |
18.3 statement indicating a desire not to establish contact |
which was filed more than 5 years prior to the search request, |
the confidential intermediary shall confirm the petitioner's |
desire to continue the search. Information
provided to the |
confidential intermediary by an adoption agency shall be
|
restricted to the full name, date of birth, place of birth, |
last known address,
last known telephone number of the |
|
sought-after relative or, if applicable,
of the children or |
siblings of the sought-after relative, and the 18.3 statement.
|
(h) Adoption agency disclosure of medical information. If |
the petitioner is
an adult adopted or surrendered person or the |
adoptive parent of a
minor and if the petitioner has signed a |
written authorization to disclose
personal medical |
information, an adoption agency disclosing information to a
|
confidential intermediary shall disclose available medical |
information about
the adopted or surrendered person from birth |
through adoption.
|
(i) Duties of confidential intermediary in conducting a |
search. In
conducting
a search under this Section, the |
confidential intermediary shall first confirm
that there is no |
Denial of Information Exchange on file with the Illinois
|
Adoption Registry. If the petitioner is an adult child of an |
adopted or surrendered person
who is deceased, the
confidential |
intermediary shall additionally confirm that the adopted or |
surrendered person
did not file a Denial of Information |
Exchange or a Birth Parent Preference Form with Option E |
selected with the Illinois Adoption
Registry during his or her |
life. If there is a Denial on file with the Registry, the |
confidential intermediary must discontinue the search unless |
the petitioner is an adult adopted or surrendered person and |
the sought-after birth relative filed the Denial 5 years or |
more prior to the search or the birth parent has not been the |
object of a search through the State confidential intermediary |
|
program for 10 or more years. If the petitioner is an adult |
adopted or surrendered person and there is a Birth Parent |
Preference Form on file with the Registry and the birth parent |
who completed the form selected Option E, the confidential |
intermediary must discontinue the search unless 5 years or more |
have elapsed since the filing of the Birth Parent Preference |
Form. If the petitioner is an adult birth sibling of
an
adopted
|
or surrendered person or an adult sibling of a birth parent who |
is deceased,
the confidential intermediary shall
additionally |
confirm that the birth parent did not file a Denial of |
Information
Exchange or a Birth Parent Preference Form with |
Option E selected with the Registry during his or her life. If |
the confidential
intermediary learns that a sought-after birth |
parent signed an 18.3 statement
indicating his or her intent |
not to have identifying information shared, and
did not later |
file an Information Exchange Authorization or a Birth Parent |
Preference Form with the
Registry, the confidential |
intermediary shall discontinue the search and inform
the |
petitioning party of the birth parent's intent, unless the |
petitioner is an adult adopted or surrendered person and 5 |
years or more have elapsed since the birth parent signed the |
statement indicating his or her intent not to have identifying |
information shared. In cases where the birth parent filed a |
Denial of Information Exchange or Birth Parent Preference Form |
where Option E was selected, or statement indicating his or her |
intent not to have identifying information shared less than 5 |
|
years prior to the search request and the petitioner is an |
adult adopted or surrendered person, the confidential |
intermediary shall inform the petitioner of the need to |
discontinue the search until 5 years have elapsed since the |
Denial of Information Exchange or Birth Parent Preference Form |
where Option E was selected, or statement
was filed; in cases |
where a birth parent was previously the subject of a search |
through the State confidential intermediary program, the |
confidential intermediary shall inform the petitioner of the |
need to discontinue the search until 10 years or more have |
elapsed since the initial search was closed. In cases where a |
birth parent has been the object of 2 searches through the |
State confidential intermediary program, no subsequent search |
for the birth parent shall be authorized absent a court order |
to the contrary.
|
In conducting a search under this Section, the confidential |
intermediary
shall attempt to locate the relative or relatives |
from whom the petitioner has
requested information. If the |
sought-after relative is deceased
or cannot be located after a |
diligent search, the
confidential intermediary may contact |
other adult relatives of the
sought-after relative.
|
The confidential intermediary shall contact a sought-after |
relative on
behalf of the petitioner in a manner that respects |
the sought-after relative's
privacy and shall inform the |
sought-after relative of the petitioner's request
for medical |
information, identifying information or contact as stated in |
|
the
petition. Based upon the terms of the petitioner's request, |
the confidential
intermediary shall contact a sought-after |
relative on behalf of the petitioner
and inform the |
sought-after relative of the following options:
|
(1) The sought-after relative may totally reject one or |
all of the
requests for medical information, identifying |
information or
contact. The sought-after relative shall be |
informed that they can
provide a medical questionnaire to |
be forwarded to the petitioner
without releasing any |
identifying information. The confidential
intermediary |
shall inform the petitioner of the sought-after
relative's |
decision to reject the sharing of information or contact.
|
(2) The sought-after relative may consent to |
completing a medical
questionnaire only. In this case, the |
confidential intermediary
shall provide the questionnaire |
and ask the sought-after relative to
complete it. The |
confidential intermediary shall forward the
completed |
questionnaire to the petitioner and inform the petitioner
|
of the sought-after relative's desire to not provide any |
additional
information.
|
(3) The sought-after relative may communicate with the |
petitioner
without having his or her identity disclosed. In |
this case, the
confidential intermediary shall arrange the |
desired communication
in a manner that protects the |
identity of the sought-after relative.
The confidential |
intermediary shall inform the petitioner of the
|
|
sought-after relative's decision to communicate but not |
disclose
his or her identity.
|
(4) The sought-after relative may consent to initiate |
contact with the
petitioner. If both the petitioner and the |
sought-after relative or
relatives are eligible to |
register with the Illinois Adoption Registry,
the |
confidential intermediary shall provide the necessary
|
application forms and request that the sought-after |
relative
register with the Illinois Adoption Registry. If |
either the petitioner
or the sought-after relative or |
relatives are ineligible to register
with the Illinois |
Adoption Registry, the confidential intermediary
shall |
obtain written consents from both parties that they wish to
|
disclose their identities to each other and to have contact |
with
each other.
|
(j) Oath. The confidential intermediary shall sign an oath |
of
confidentiality substantially as follows: "I, .........., |
being duly sworn, on
oath depose and say: As a condition of |
appointment as a confidential
intermediary, I affirm that:
|
(1) I will not disclose to the petitioner,
directly or |
indirectly, any confidential information
except in a |
manner consistent with the
law.
|
(2) I recognize that violation of this oath subjects me |
to civil liability
and to a potential finding of contempt |
of court.
................................
|
SUBSCRIBED AND SWORN to before me, a Notary Public, on (insert
|
|
date)
|
................................."
|
(k) Sanctions.
|
(1) Any confidential intermediary who improperly |
discloses
confidential information identifying a |
sought-after relative shall be liable to
the sought-after |
relative for damages and may also be found in contempt of
|
court.
|
(2) Any person who learns a sought-after
relative's |
identity, directly or indirectly, through the use of |
procedures
provided in this Section and who improperly |
discloses information identifying
the sought-after |
relative shall be liable to the sought-after relative for
|
actual damages plus minimum punitive damages of $10,000.
|
(3) The Department shall fine any confidential |
intermediary who improperly
discloses
confidential |
information in violation of item (1) or (2) of this |
subsection (k)
an amount up to $2,000 per improper |
disclosure. This fine does not affect
civil liability under |
item (2) of this subsection (k). The Department shall
|
deposit all fines and penalties collected under this |
Section into the Illinois
Adoption Registry and Medical |
Information Fund.
|
(l) Death of person being sought. Notwithstanding any other |
provision
of this Act, if the confidential intermediary |
discovers that the person
being sought has died, he or she |
|
shall report this fact to the court,
along with a copy of the |
death certificate. If the sought-after relative is a birth |
parent, the confidential intermediary shall also forward a copy |
of the birth parent's death certificate, if available, to the |
Registry for inclusion in the Registry file.
|
(m) Any confidential information obtained by the |
confidential intermediary
during the course of his or her |
search shall be kept strictly confidential
and shall be used |
for the purpose of arranging contact between the
petitioner and |
the sought-after birth relative. At the time the case is
|
closed, all identifying information shall be returned to the |
court for
inclusion in the impounded adoption file.
|
(n) If the petitioner is an adopted or surrendered person |
21 years of age or over or the
adoptive parent or legal |
guardian of an adopted or surrendered person under the age
of |
21, any
non-identifying information, as defined in Section |
18.4, that is
ascertained during the course of the search may |
be given in writing to
the petitioner at any time during the |
search before the case is closed.
|
(o) Except as provided in subsection (k) of this Section, |
no liability shall
accrue to
the State, any State agency, any |
judge, any officer or employee of the
court, any certified |
confidential intermediary, or any agency designated
to oversee |
confidential intermediary services for acts, omissions, or
|
efforts made in good faith within the scope of this Section.
|
(p) An adoption agency that has received a request from a |
|
confidential intermediary for the full name, date of birth, |
last known address, or last known telephone number of a |
sought-after relative pursuant to subsection (g) of Section |
18.3a, or for medical information regarding a sought-after |
relative pursuant to subsection (h) of Section 18.3a, must |
satisfactorily comply with this court order within a period of |
45 days. The court shall order the adoption agency to reimburse |
the petitioner in an amount equal to all payments made by the |
petitioner to the confidential intermediary, and the adoption |
agency shall be subject to a civil monetary penalty of $1,000 |
to be paid to the Department of Children and Family Services. |
Following the issuance of a court order finding that the |
adoption agency has not complied with Section 18.3, the |
adoption agency shall be subject to a monetary penalty of $500 |
per day for each subsequent day of non-compliance. Proceeds |
from such fines shall be utilized by the Department of Children |
and Family Services to subsidize the fees of petitioners as |
referenced in subsection (d) of this Section. |
(q) Provide information to eligible petitioner. The |
confidential intermediary may provide to eligible petitioners |
as described in subsections (a) and (b) of this Section, the |
name of the child welfare agency which had legal custody of the |
surrendered person or responsibility for placing the |
surrendered person and any available contact information for |
such agency. In addition, the confidential intermediary may |
provide to such petitioners the name of the state in which the |
|
surrender occurred or in which the adoption was finalized. |
Any reimbursements and fines, notwithstanding any |
reimbursement directly to the petitioner, paid under this |
subsection are in addition to other remedies a court may |
otherwise impose by law. |
The Department of Children and Family Services shall submit |
reports to the Adoption Advisory Council Confidential |
Intermediary Advisory Council by July 1 and January 1 of each |
year in order to report the penalties assessed and collected |
under this subsection, the amounts of related deposits into the |
DCFS Children's Services Fund, and any expenditures from such |
deposits.
|
(Source: P.A. 96-661, eff. 8-25-09; 96-895, eff. 5-21-10; |
97-110, eff. 7-14-11.)
|
(750 ILCS 50/18.07 rep.)
|
Section 15. The Adoption Act is amended by repealing |
Section 18.07.
|
Section 99. Effective date. This Act takes effect January |
1, 2013, except this Section and
Section 5 take effect upon |
becoming law.
|