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1 | | (b) A certificate of adoption or a certified copy of |
2 | | the order of
adoption entered in a court of competent |
3 | | jurisdiction of any other state or
country declaring |
4 | | adopted a child born in the State of Illinois, together
|
5 | | with the information necessary to identify the original |
6 | | certificate of
birth and to establish the new certificate |
7 | | of birth; except that a new
certificate of birth shall not |
8 | | be established if so requested by the court
ordering the |
9 | | adoption, the adoptive parents, or the adopted person.
|
10 | | (c) A request that a new certificate be established and |
11 | | such evidence as
required by regulation proving that such |
12 | | person has been legitimatized, or
that the circuit court, |
13 | | the Department of Healthcare and Family Services (formerly
|
14 | | Illinois Department of Public Aid), or
a court or |
15 | | administrative agency of any other state
has established
|
16 | | the paternity of such a person
by judicial or |
17 | | administrative processes or by voluntary acknowledgment,
|
18 | | which is accompanied by the social security
numbers of all |
19 | | persons determined and presumed to be the parents.
|
20 | | (d) An affidavit by a physician that he has performed |
21 | | an operation on a
person, and that by reason of the |
22 | | operation the sex designation on such
person's birth record |
23 | | should be changed. The State Registrar of Vital
Records may |
24 | | make any investigation or require any further information |
25 | | he
deems necessary.
|
26 | | Each request for a new certificate of birth shall be |
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1 | | accompanied by a fee
of $15 and entitles the applicant to one |
2 | | certification or certified copy
of the new certificate. If the |
3 | | request is for additional copies, it shall
be accompanied by a |
4 | | fee of $2 for each additional certification or certified
copy.
|
5 | | (2) When a new certificate of birth is established, the |
6 | | actual place and
date of birth shall be shown; provided, in the |
7 | | case of adoption of a person
born in this State by parents who |
8 | | were residents of this State at the time
of the birth of the |
9 | | adopted person, the place of birth may be shown as the
place of |
10 | | residence of the adoptive parents at the time of such person's
|
11 | | birth, if specifically requested by them, and any new |
12 | | certificate of birth
established prior to the effective date of |
13 | | this amendatory Act may be
corrected accordingly if so |
14 | | requested by the adoptive parents or the
adopted person when of |
15 | | legal age. The social security numbers of the
parents shall not |
16 | | be recorded on the certificate of birth. The social
security |
17 | | numbers may only be used for purposes allowed under federal |
18 | | law.
The new certificate shall be substituted for the original |
19 | | certificate of birth:
|
20 | | (a) Thereafter, the original certificate and the |
21 | | evidence of adoption,
paternity, legitimation, or sex |
22 | | change shall not be subject to inspection
or certification |
23 | | except upon order of the circuit court or
as provided by |
24 | | regulation. If the new certificate was issued subsequent to |
25 | | an adoption, the original certificate shall not be subject |
26 | | to inspection until the adopted person has reached the age |
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1 | | of 21; thereafter, the original certificate shall be made |
2 | | available as provided by Section 18.1b of the Adoption Act.
|
3 | | (b) Upon receipt of notice of annulment of adoption, |
4 | | the original
certificate of birth shall be restored to its |
5 | | place in the files, and the
new certificate and evidence |
6 | | shall not be subject to inspection or
certification except |
7 | | upon order of the circuit court.
|
8 | | (3) If no certificate of birth is on file for the person |
9 | | for whom a new
certificate is to be established under this |
10 | | Section, a delayed record of
birth shall be filed with the |
11 | | State Registrar of Vital Records as provided
in Section 14 or |
12 | | Section 15 of this Act before a new certificate of birth
is |
13 | | established, except that when the date and place of birth and |
14 | | parentage
have been established in the adoption proceedings, a |
15 | | delayed record shall
not be required.
|
16 | | (4) When a new certificate of birth is established by the |
17 | | State
Registrar of Vital Records, all copies of the original |
18 | | certificate of birth
in the custody of any custodian of |
19 | | permanent local records in this State
shall be transmitted to |
20 | | the State Registrar of Vital Records as directed,
and shall be |
21 | | sealed from inspection except as provided by Section 18.1b of |
22 | | the Adoption Act .
|
23 | | (5) Nothing in this Section shall be construed to prohibit |
24 | | the amendment
of a birth certificate in accordance with |
25 | | subsection (6) of Section 22.
|
26 | | (Source: P.A. 95-331, eff. 8-21-07.)
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1 | | Section 10. The Adoption Act is amended by changing |
2 | | Sections 18.06, 18.1, 18.1a, 18.1b, 18.2, 18.3a, and 18.6 as |
3 | | follows:
|
4 | | (750 ILCS 50/18.06)
|
5 | | Sec. 18.06. Definitions. When used in Sections
18.05 |
6 | | through Section 18.6, for the purposes of the Registry:
|
7 | | "Adopted person" means a person who was adopted
pursuant to |
8 | | the laws in effect at the time of the adoption.
|
9 | | "Adoptive parent" means a person who has become a parent |
10 | | through the legal
process of adoption.
|
11 | | "Adult child" means the biological child 21 years of age or |
12 | | over of a deceased adopted or surrendered person.
|
13 | | "Adult Adopted or Surrendered Person" means an adopted or |
14 | | surrendered person 21 years of age or over. |
15 | | "Agency" means a public child welfare agency or a licensed |
16 | | child welfare
agency.
|
17 | | "Birth aunt" means the adult full or half sister of a |
18 | | deceased birth parent.
|
19 | | "Birth father" means the biological father of an adopted or |
20 | | surrendered
person who is named on the original certificate of |
21 | | live birth or on a consent
or surrender document, or a |
22 | | biological father whose paternity has been
established by a |
23 | | judgment or order of the court, pursuant to the Illinois
|
24 | | Parentage Act of 1984.
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1 | | "Birth mother" means the biological mother of an adopted or |
2 | | surrendered
person.
|
3 | | "Birth parent" means a birth mother or birth father of an |
4 | | adopted or
surrendered person.
|
5 | | "Birth Parent Preference Form" means the form prepared by |
6 | | the Department of Public Health pursuant to Section 18.2 |
7 | | completed by a birth parent registrant and filed with the |
8 | | Registry that indicates the birth parent's preferences |
9 | | regarding contact and , if applicable, the release of his or her |
10 | | identifying information on the non-certified copy of the |
11 | | original birth certificate released to an adult adopted or |
12 | | surrendered person or to the surviving adult child or surviving |
13 | | spouse of a deceased adopted or surrendered person who has |
14 | | filed a Request for a Non-Certified Copy of an Original Birth |
15 | | Certificate. |
16 | | "Birth relative" means a birth mother, birth father, birth |
17 | | sibling, birth aunt, or birth uncle.
|
18 | | "Birth sibling" means the adult full or half sibling
of an |
19 | | adopted or
surrendered person.
|
20 | | "Birth uncle" means the adult full or half brother of a |
21 | | deceased birth parent.
|
22 | | "Confidential intermediary" means an individual certified |
23 | | by the Department of Children and Family Services pursuant to |
24 | | Section 18.3a(e). |
25 | | "Denial of Information Exchange" means an affidavit |
26 | | completed by a
registrant with the Illinois Adoption Registry |
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1 | | and Medical Information Exchange
denying the release of |
2 | | identifying information which has been filed with the Registry.
|
3 | | "Information Exchange Authorization" means
an affidavit |
4 | | completed by a registrant with the Illinois Adoption Registry |
5 | | and
Medical Information Exchange authorizing the release of |
6 | | identifying
information which has been filed with the Registry.
|
7 | | "Medical Information Exchange Questionnaire" means the |
8 | | medical
history
questionnaire completed by a registrant of the |
9 | | Illinois Adoption Registry and
Medical Information Exchange.
|
10 | | "Non-certified Copy of the Original Birth Certificate" |
11 | | means a non-certified copy of the original certificate of live |
12 | | birth of an adult adopted or surrendered person who was born in |
13 | | Illinois. |
14 | | "Proof of death" means a death certificate.
|
15 | | "Registrant" or "Registered Party" means a birth parent, |
16 | | birth sibling,
birth aunt, birth uncle, adopted or surrendered |
17 | | person 21 years of age or over, adoptive parent or legal
|
18 | | guardian of an adopted or surrendered person under the age of |
19 | | 21, or adoptive parent, surviving spouse, or adult child of a |
20 | | deceased adopted or surrendered person who has filed
an |
21 | | Illinois Adoption Registry Application or Registration |
22 | | Identification Form
with the Registry.
|
23 | | "Registry" means the Illinois Adoption Registry and |
24 | | Medical Information Exchange. |
25 | | "Request for a Non-Certified Copy of an Original Birth |
26 | | Certificate" means an affidavit completed by an adult adopted |
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1 | | or surrendered person or by the surviving adult child or |
2 | | surviving spouse of a deceased adopted or surrendered person |
3 | | and filed with the Registry requesting a non-certified copy of |
4 | | an adult adopted or surrendered person's original certificate |
5 | | of live birth in Illinois. |
6 | | "Surrendered person" means a person whose parents' rights |
7 | | have been
surrendered or terminated but who has not been |
8 | | adopted.
|
9 | | "Surviving spouse" means the wife or husband , 21 years of |
10 | | age or older, of a deceased adopted or surrendered person who |
11 | | would be 21 years of age or older if still alive and who has one |
12 | | or more surviving biological children who are under the age of |
13 | | 21.
|
14 | | "18.3 Statement" means a statement regarding the |
15 | | disclosure of identifying information signed by a birth parent |
16 | | under Section 18.3 of this Act as it existed immediately prior |
17 | | to the effective date of this amendatory Act of the 96th |
18 | | General Assembly. |
19 | | (Source: P.A. 96-895, eff. 5-21-10.)
|
20 | | (750 ILCS 50/18.1) (from Ch. 40, par. 1522.1)
|
21 | | Sec. 18.1. Disclosure of identifying information.
|
22 | | (a) The Department of Public Health shall establish and |
23 | | maintain a
Registry for the purpose of allowing mutually
|
24 | | consenting members of birth and adoptive families to exchange |
25 | | identifying and medical information. Identifying information |
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1 | | for
the purpose of this Act shall mean any one or more of the |
2 | | following:
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3 | | (1) The name and last known address of the consenting |
4 | | person or persons.
|
5 | | (2) A copy of the Illinois Adoption Registry |
6 | | Application of the
consenting person or persons.
|
7 | | (3) A non-certified copy of the original birth |
8 | | certificate of an adult adopted
or surrendered person.
|
9 | | (b) Written authorization from all parties identified must |
10 | | be received prior
to disclosure of any identifying information, |
11 | | with the exception of non-certified copies of original birth |
12 | | certificates released to adult adopted or surrendered persons |
13 | | or to surviving adult children and surviving spouses of |
14 | | deceased adopted or surrendered persons pursuant to the |
15 | | procedures outlined in Section 18.1b(e).
|
16 | | (c) At any time after a child is surrendered for adoption, |
17 | | or at any
time during the adoption proceedings or at any time |
18 | | thereafter, either
birth parent or both of them may file with |
19 | | the Registry a Birth
Parent Registration Identification Form |
20 | | and an Information Exchange
Authorization or a Denial of |
21 | | Information Exchange .
|
22 | | (d) A birth sibling 21 years of age or over who was not |
23 | | surrendered for
adoption and who has submitted a copy of his or |
24 | | her birth certificate as well as proof of death for a deceased |
25 | | birth parent
and such birth parent did not file a Denial of |
26 | | Information Exchange or a Birth Parent Preference Form on which |
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1 | | Option E was selected with the
Registry prior to his or her |
2 | | death may file a Registration Identification Form
and an |
3 | | Information Exchange Authorization or a Denial of Information |
4 | | Exchange.
|
5 | | (e) A birth aunt or birth uncle who has submitted birth |
6 | | certificates for himself or herself and for a deceased birth |
7 | | parent naming at least one common biological parent as well as |
8 | | proof of death for the deceased birth parent and such birth |
9 | | parent did not file a Denial of Information Exchange or a Birth |
10 | | Parent Preference Form on which Option E was selected with the |
11 | | Registry prior to his or her death may file a Registration |
12 | | Identification Form and an Information Exchange Authorization |
13 | | or a Denial of Information Exchange.
|
14 | | (f) Any adopted person 21 years of age or over, any |
15 | | surrendered person
21 years of age or over, or any adoptive |
16 | | parent or legal guardian of an
adopted or surrendered person |
17 | | under the age of 21 may file with the Registry
a Registration |
18 | | Identification Form and an Information Exchange Authorization
|
19 | | or a Denial of Information Exchange.
|
20 | | (g) Any adult child 21 years of age or over of a deceased |
21 | | adopted or surrendered person who has submitted a copy of his |
22 | | or her birth certificate naming an adopted or surrendered |
23 | | person as his or her biological parent as well as proof of |
24 | | death for the deceased adopted or surrendered person and such |
25 | | adopted or surrendered person did not file a Denial of |
26 | | Information Exchange with the Registry prior to his or her |
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1 | | death may file a Registration Identification Form and an |
2 | | Information Exchange Authorization or a Denial of Information |
3 | | Exchange.
|
4 | | (h) Any surviving spouse of a deceased adopted or |
5 | | surrendered person 21 years of age or over who has submitted |
6 | | proof of death for the deceased adopted or surrendered person |
7 | | and such adopted or surrendered person did not file a Denial of |
8 | | Information Exchange with the Registry prior to his or her |
9 | | death as well as a birth certificate naming themselves and the |
10 | | adopted or surrendered person as the parents of a minor child |
11 | | under the age of 21 may file a Registration Identification Form |
12 | | and an Information Exchange Authorization or a Denial of |
13 | | Information Exchange.
|
14 | | (i) Any adoptive parent or legal guardian of a deceased |
15 | | adopted or surrendered person who is 21 years of age or over |
16 | | who has submitted proof of death as well as proof of parentage |
17 | | or guardianship for the deceased adopted or surrendered person |
18 | | and such adopted or surrendered person did not file a Denial of |
19 | | Information Exchange with the Registry prior to his or her |
20 | | death may file a Registration Identification Form and an |
21 | | Information Exchange Authorization or a Denial of Information |
22 | | Exchange.
|
23 | | (j) The Department of Public Health shall supply to the |
24 | | adopted or
surrendered person or his or her adoptive parents, |
25 | | legal guardians, adult children or surviving spouse, and
to the |
26 | | birth parents identifying information only if both the adopted |
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1 | | or
surrendered person, or one of his or her adoptive parents, |
2 | | legal guardians, adult children or his or her surviving spouse, |
3 | | and
the birth parents have filed with the Registry an |
4 | | Information Exchange
Authorization or a Birth Parent |
5 | | Preference Form on which Option A, B, or C was selected and the |
6 | | information at the Registry indicates that the
consenting |
7 | | adopted or surrendered person, the child of the consenting
|
8 | | adoptive parents or legal guardians, the parent of the |
9 | | consenting adult child of the adopted or surrendered person, or |
10 | | the deceased wife or husband of the consenting surviving spouse
|
11 | | is the child of the consenting birth
parents, except |
12 | | identifying information that appears on a non-certified copy of |
13 | | an original birth certificate may be provided to an adult |
14 | | adopted or surrendered person or to the surviving adult child |
15 | | or surviving spouse of a deceased adopted or surrendered person |
16 | | pursuant to the procedures outlined in Section 18.1b(e) of this |
17 | | Act.
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18 | | The Department of Public Health shall supply to adopted or |
19 | | surrendered
persons who are birth siblings identifying |
20 | | information only if both siblings
have filed with the Registry |
21 | | an Information Exchange Authorization and the
information at |
22 | | the Registry indicates that the consenting siblings have one
or |
23 | | both birth parents in common. Identifying information shall be |
24 | | supplied to
consenting birth siblings who were adopted or |
25 | | surrendered if any such sibling
is 21 years of age or over. |
26 | | Identifying information shall be supplied to
consenting birth |
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1 | | siblings who were not adopted or surrendered if any such
|
2 | | sibling is 21 years of age or over and has proof of death of the |
3 | | common birth
parent and such birth parent did not file a Denial |
4 | | of Information Exchange or a Birth Parent Preference Form on |
5 | | which Option E was selected
with the Registry prior to his or |
6 | | her death.
|
7 | | (k) The Department of Public Health shall supply to the |
8 | | adopted or surrendered person or his or her adoptive parents, |
9 | | legal guardians, adult children or surviving spouse, and to a |
10 | | birth aunt identifying information only if both the adopted or |
11 | | surrendered person or one of his or her adoptive parents, legal |
12 | | guardians, adult children or his or her surviving spouse, and |
13 | | the birth aunt have filed with the Registry an Information |
14 | | Exchange Authorization and the information at the Registry |
15 | | indicates that the consenting adopted or surrendered person, or |
16 | | the child of the consenting adoptive parents or legal |
17 | | guardians, or the parent of the consenting adult child, or the |
18 | | deceased wife or husband of the consenting surviving spouse of |
19 | | the adopted or surrendered person is or was the child of the |
20 | | brother or sister of the consenting birth aunt.
|
21 | | (l) The Department of Public Health shall supply to the |
22 | | adopted or surrendered person or his or her adoptive parents, |
23 | | legal guardians, adult children or surviving spouse, and to a |
24 | | birth uncle identifying information only if both the adopted or |
25 | | surrendered person or one of his or her adoptive parents, legal |
26 | | guardians, adult children or his or her surviving spouse, and |
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1 | | the birth uncle have filed with the Registry an Information |
2 | | Exchange Authorization and the information at the Registry |
3 | | indicates that the consenting adopted or surrendered person, or |
4 | | the child of the consenting adoptive parents or legal |
5 | | guardians, or the parent of the consenting adult child, or the |
6 | | deceased wife or husband of the consenting surviving spouse of |
7 | | the adopted or surrendered person is or was the child of the |
8 | | brother or sister of the consenting birth uncle.
|
9 | | (m) A registrant
may notify the Registry of his or her
|
10 | | desire not to have identifying information revealed or may |
11 | | revoke any previously
filed Information Exchange Authorization |
12 | | by completing and filing with the
Registry a Registry |
13 | | Identification Form along with a Denial of Information
Exchange |
14 | | or, if applicable, a Birth Parent Preference Form . Any |
15 | | registrant, except a birth parent, may revoke his or her Denial |
16 | | of Information Exchange by filing
an Information Exchange |
17 | | Authorization. A birth parent may revoke a Denial of |
18 | | Information Exchange by filing a Birth Parent Preference Form. |
19 | | Any birth parent who has previously filed a Birth Parent |
20 | | Preference Form where Option E was selected may revoke such |
21 | | preference by filing a subsequent Birth Parent Preference Form |
22 | | and selecting Option A, B, C, or D. The Department of Public |
23 | | Health shall
act in accordance with the most recently filed |
24 | | affidavit.
|
25 | | (n) Identifying information ascertained from the Registry |
26 | | shall be
confidential and may be disclosed only (1) upon a |
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1 | | Court Order, which order
shall name the person or persons |
2 | | entitled to the information, or (2) to a registrant who is the |
3 | | subject of an Information Exchange
Authorization or, if |
4 | | applicable, a Birth Parent Preference Form that was completed |
5 | | by another registrant and filed with the Illinois Adoption |
6 | | Registry and Medical Information Exchange, or (3) as authorized |
7 | | under subsection (h) of Section 18.3 of
this Act, or (4) |
8 | | pursuant to the procedures outlined in Section 18.1b(e) of this |
9 | | Act. Any person who willfully provides unauthorized
disclosure |
10 | | of any information filed with the Registry or who knowingly or
|
11 | | intentionally files false information with the Registry shall |
12 | | be guilty of
a Class A misdemeanor and shall be liable for |
13 | | damages.
|
14 | | (o) If information is disclosed pursuant to this Act, the |
15 | | Department shall
redact it to remove any identifying |
16 | | information about any party who has not
consented to the |
17 | | disclosure of such identifying information, or, in the case of |
18 | | identifying information on the original birth certificate, |
19 | | pursuant to Section 18.1b(e) of this Act.
|
20 | | (Source: P.A. 96-895, eff. 5-21-10.)
|
21 | | (750 ILCS 50/18.1a)
|
22 | | Sec. 18.1a. Registry matches.
|
23 | | (a) The Registry shall release identifying information, as |
24 | | specified on
the applicant's Information Exchange |
25 | | Authorization or, if applicable, a Birth Parent Preference |
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1 | | Form , to the following
mutually consenting registered parties
|
2 | | and provide them with any photographs or correspondence which |
3 | | have been placed in the
Adoption/Surrender Records File and
are |
4 | | specifically intended for the registered parties:
|
5 | | (i) an adult adopted or surrendered person and one of |
6 | | his or her birth
relatives who have both filed an |
7 | | applicable Information
Exchange Authorization or, if |
8 | | applicable, a Birth Parent Preference Form specifying the |
9 | | other consenting party with the Registry,
if
information |
10 | | available to the Registry
confirms that the consenting |
11 | | adopted or surrendered person is biologically related to |
12 | | the consenting birth relative;
|
13 | | (ii) the adoptive parent or legal guardian of an |
14 | | adopted or surrendered
person under the age of 21
and one |
15 | | of the adopted or surrendered person's birth relatives who
|
16 | | have both filed an Information Exchange Authorization |
17 | | specifying the other
consenting party with the Registry , |
18 | | or, if applicable, a Birth Parent Preference Form, with the |
19 | | Registry, if
information available to the Registry |
20 | | confirms that the child of the consenting
adoptive parent |
21 | | or legal guardian is biologically related to the
consenting
|
22 | | birth relative; and
|
23 | | (iii) the adoptive parent, adult child or surviving |
24 | | spouse of a deceased adopted or surrendered person, and one |
25 | | of the adopted or surrendered person's birth relatives who |
26 | | have both filed an applicable Information Exchange |
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1 | | Authorization specifying the other consenting party with |
2 | | the Registry, or, if applicable, a Birth Parent Preference |
3 | | Form, with the Registry, if information available to the |
4 | | Registry confirms that the child of the consenting adoptive |
5 | | parent, the parent of the consenting adult child or the |
6 | | deceased wife or husband of the consenting surviving spouse |
7 | | of the adopted or surrendered person was biologically |
8 | | related to the consenting birth relative.
|
9 | | (b) If a registrant is the subject of a Denial of
|
10 | | Information Exchange filed by another registered party or is an |
11 | | adopted or surrendered person, or the surviving relative of a |
12 | | deceased adopted or surrendered person, and a birth parent of |
13 | | the adopted or surrendered person completed a Birth Parent |
14 | | Preference Form and selected Option E , the Registry shall
not |
15 | | release identifying information to either registrant or, if |
16 | | applicable, to an adopted person who has requested a copy of |
17 | | his or her original birth certificate, with the exception of |
18 | | non-certified copies of the original birth certificate |
19 | | released under Section 18.1b(e), and as to a birth parent who |
20 | | has prohibited release of identifying information on the |
21 | | original birth certificate to the adult adopted or surrendered |
22 | | person, upon the death of said birth parent.
|
23 | | (c) If a registrant has completed a Medical Information |
24 | | Exchange
Questionnaire and has consented to its disclosure, |
25 | | that Questionnaire shall be
released to any registered party |
26 | | who has indicated their desire to receive such
information on |
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1 | | his or her Illinois Adoption Registry Application, if
|
2 | | information available to the Registry
confirms that the |
3 | | consenting parties are biologically related, that the |
4 | | consenting
birth relative and the child of the consenting |
5 | | adoptive parents or legal
guardians are birth relatives, or |
6 | | that the consenting birth relative and the deceased wife or |
7 | | husband of the consenting surviving spouse are birth relatives.
|
8 | | (Source: P.A. 96-895, eff. 5-21-10.)
|
9 | | (750 ILCS 50/18.1b)
|
10 | | Sec. 18.1b. The Illinois Adoption Registry Application. |
11 | | The Illinois
Adoption Registry Application shall substantially |
12 | | include the following:
|
13 | | (a) General Information. The Illinois Adoption Registry
|
14 | | Application shall include the space to provide Information |
15 | | about the registrant
including his or her
surname, given name |
16 | | or names, social security number (optional), mailing
address, |
17 | | home telephone number, gender, date and place of birth, and the |
18 | | date
of registration. If applicable and known
to the |
19 | | registrant, he or she may include the maiden surname of the
|
20 | | birth mother, any subsequent surnames of the birth mother, the |
21 | | surname of the
birth father, the given name or names of the |
22 | | birth parents, the dates and
places of birth of the birth |
23 | | parents, the surname and given name or names of
the adopted |
24 | | person prior to adoption, the gender and date and place of |
25 | | birth of
the adopted or surrendered person, the name of the |
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1 | | adopted person following
his or her adoption and the state and |
2 | | county where the judgment of adoption was
finalized.
|
3 | | (b) Medical Information Exchange Questionnaire. In |
4 | | recognition of
the importance of medical information and of |
5 | | recent discoveries regarding the
genetic origin of many medical |
6 | | conditions and diseases all registrants shall be
asked to |
7 | | voluntarily complete a Medical
Information Exchange |
8 | | Questionnaire. The Medical Information Exchange Questionnaire |
9 | | shall include a comprehensive check-list of medical conditions |
10 | | and diseases including those of genetic origin.
|
11 | | (1) For birth relatives, the Medical Information |
12 | | Exchange
Questionnaire
shall
include a comprehensive |
13 | | check-list of medical
conditions and diseases including |
14 | | those of genetic origin. Birth relatives shall be asked to |
15 | | indicate all genetically-inherited diseases
and
conditions |
16 | | on this
list which are known to exist in the adopted or |
17 | | surrendered person's birth
family at the time of |
18 | | registration.
In addition, all birth relatives
shall be |
19 | | apprised of the Registry's provisions for voluntarily |
20 | | submitting
information about their and their family's |
21 | | medical
histories on a confidential, ongoing basis.
|
22 | | (2) Adopted and surrendered persons and their adoptive |
23 | | parents, legal
guardians, adult children, and surviving |
24 | | spouses shall be asked to indicate all
|
25 | | genetically-inherited diseases and medical conditions with |
26 | | which the adopted or
surrendered person or, if applicable, |
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1 | | his or her children have been diagnosed
since birth.
|
2 | | (3) The Medical Information Exchange Questionnaire
|
3 | | shall include a space where the registrant may authorize |
4 | | the release of the
Medical Information Exchange |
5 | | Questionnaire to specified registered parties and a
|
6 | | disclaimer
informing registrants that the Department of |
7 | | Public Health cannot guarantee the
accuracy of medical |
8 | | information exchanged through the Registry.
|
9 | | (c) Written statement. All registrants shall be given the
|
10 | | opportunity to voluntarily file a written statement with the |
11 | | Registry. This
statement
shall be submitted in the space |
12 | | provided.
No written statement submitted to the Registry
shall |
13 | | include identifying information pertaining to any person other |
14 | | than the
registrant who submitted it.
Any such identifying |
15 | | information shall be redacted by the Department or
returned for |
16 | | removal of identifying information.
|
17 | | (d) Exchange of information. All registrants except birth |
18 | | parents may indicate their
wishes regarding contact and the |
19 | | exchange of identifying and/or medical information with any |
20 | | other registrant by completing an
Information Exchange |
21 | | Authorization or a Denial of Information Exchange. Birth |
22 | | parents may indicate their wishes regarding contact by filing a |
23 | | Birth Parent Preference Form pursuant to the procedures |
24 | | outlined in this Section.
|
25 | | (1) Information Exchange Authorization. Adopted or |
26 | | surrendered persons 21
years of age or over who are |
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1 | | interested in exchanging identifying and/or medical |
2 | | information or would welcome contact with one or more of |
3 | | their
birth relatives; birth parents
who are interested in |
4 | | exchanging identifying and/or medical information or would |
5 | | welcome contact with an adopted or surrendered
person 21 |
6 | | years of age or over, or one or more of his or her adoptive |
7 | | parents, legal guardians, adult children, or a surviving |
8 | | spouse;
birth siblings 21 years of age or over who were |
9 | | adopted or surrendered and who
are interested in exchanging |
10 | | identifying and/or medical information or would welcome |
11 | | contact with an adopted or surrendered person, or one or |
12 | | more of
his or her adoptive parents, legal guardians, adult |
13 | | children, or a surviving spouse; birth siblings 21 years of |
14 | | age
or
over who were not surrendered and who have submitted |
15 | | proof of death for any
common
birth parent
who did not file |
16 | | a Denial of Information Exchange or a Birth Parent |
17 | | Preference Form on which Option E was selected prior to his |
18 | | or her death,
and who are interested in exchanging |
19 | | identifying and/or medical information or would welcome |
20 | | contact with an adopted or surrendered person, or one or
|
21 | | more of his or her adoptive parents,
legal guardians, adult |
22 | | children, or a surviving spouse; birth aunts and birth |
23 | | uncles 21 years of age or over who have submitted birth |
24 | | certificates for themselves and a deceased birth parent |
25 | | naming at least one common biological parent as well as |
26 | | proof of death for a deceased birth parent and who are |
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1 | | interested in exchanging identifying and/or medical |
2 | | information or would welcome contact with an adopted or |
3 | | surrendered person 21 years of age or over, or one or more |
4 | | of his or her adoptive parents, legal guardians, adult |
5 | | children or a surviving spouse;
adoptive parents or
legal |
6 | | guardians of
adopted or surrendered persons under the age |
7 | | of 21 who are interested in exchanging identifying and/or |
8 | | medical information or would welcome
contact with one or |
9 | | more of the adopted or surrendered person's birth |
10 | | relatives; adoptive parents and legal guardians of |
11 | | deceased adopted or surrendered persons 21 years of age or |
12 | | over who have submitted proof of death for a deceased |
13 | | adopted or surrendered person who did not file a Denial of |
14 | | Information Exchange prior to his or her death and who are |
15 | | interested in exchanging identifying and/or medical |
16 | | information or would welcome contact with one or more of |
17 | | the adopted or surrendered person's birth relatives; adult |
18 | | children of deceased adopted or surrendered persons who |
19 | | have submitted a birth certificate naming the adopted or |
20 | | surrendered person as their biological parent and proof of |
21 | | death for an adopted or surrendered person who did not file |
22 | | a Denial of Information Exchange prior to his or her death; |
23 | | and surviving spouses of deceased adopted or surrendered |
24 | | persons who have submitted a marriage certificate naming an |
25 | | adopted or surrendered person as their deceased wife or |
26 | | husband and proof of death for an adopted or surrendered |
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1 | | person who did not file a Denial of Information Exchange |
2 | | prior to his or her death and who are interested in |
3 | | exchanging identifying and/or medical information or would |
4 | | welcome contact with one or more of the adopted or |
5 | | surrendered person's birth relatives may specify with whom |
6 | | they
wish to exchange identifying information by
filing an |
7 | | Information Exchange Authorization.
|
8 | | (2) Denial of Information Exchange. Adopted or |
9 | | surrendered persons 21
years of age or over who do not wish |
10 | | to exchange identifying information or establish contact |
11 | | with one or
more of their birth relatives may specify
with |
12 | | whom they do not wish to exchange
identifying information |
13 | | or do not wish to establish contact by filing a Denial of
|
14 | | Information Exchange. Birth relatives other than birth |
15 | | parents who do not wish to
establish contact with an
|
16 | | adopted or surrendered person or one or more of his or her |
17 | | adoptive parents,
legal guardians, or adult children may |
18 | | specify with whom they do not wish to exchange identifying
|
19 | | information or do not wish to establish contact by filing a |
20 | | Denial of Information Exchange. Birth parents who wish to |
21 | | prohibit the release of their identifying information on |
22 | | the original birth certificate released to an adult adopted |
23 | | or surrendered person who was born after January 1, 1946, |
24 | | or to the surviving adult child or surviving spouse of a |
25 | | deceased adopted or surrendered person who was born after |
26 | | January 1, 1946, may do so by filing a Denial with the |
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1 | | Registry on or before December 31, 2010. As of January 1, |
2 | | 2011, birth parents who wish to prohibit the release of |
3 | | identifying information on the non-certified copy of the |
4 | | original birth certificate released to an adult adopted |
5 | | surrendered person or to the surviving adult child or |
6 | | surviving spouse of a deceased adopted or surrendered |
7 | | person may do so by selecting Option E on a Birth Parent |
8 | | Preference Form and filing the Form with the Registry. |
9 | | Adoptive parents or
legal guardians of adopted or |
10 | | surrendered persons under the age of 21 who do
not wish to |
11 | | establish contact with one or more of the adopted or
|
12 | | surrendered person's birth relatives may specify with whom |
13 | | they
do not wish to exchange identifying
information by |
14 | | filing a Denial of Information Exchange. Adoptive parents, |
15 | | adult children, and surviving spouses of deceased adoptees |
16 | | who do not wish to exchange identifying information or |
17 | | establish contact with one or more of the adopted or |
18 | | surrendered person's birth relatives may specify with whom |
19 | | they do not wish to exchange identifying information or do |
20 | | not wish to establish contact by filing a Denial of |
21 | | Information Exchange.
|
22 | | (3) Birth Parent Preference Form. Beginning January 1, |
23 | | 2011, birth parents who are eligible to register with the |
24 | | Illinois Adoption Registry and Medical Information |
25 | | Exchange and whose birth child was born on or after January |
26 | | 1, 1946 may who wish to communicate their wishes regarding |
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1 | | contact or may prohibit and/or the release of their |
2 | | identifying information on the non-certified copy of the |
3 | | original birth certificate released under subsection (e) |
4 | | of this Section by filing to an adult adopted or |
5 | | surrendered person or the surviving adult child or |
6 | | surviving spouse of a deceased adopted or surrendered |
7 | | person who has requested a copy of the adopted or |
8 | | surrendered person's original birth certificate by filing |
9 | | a Request for a Non-Certified Copy of an Original Birth |
10 | | Certificate pursuant to subsection (e) of this Section, may |
11 | | file a Birth Parent Preference Form with the Registry. |
12 | | Birth parents whose birth child was born before January 1, |
13 | | 1946, may communicate their wishes regarding contact by |
14 | | completing a Birth Parent Preference Form, selecting |
15 | | Option A, B, C, or D, and filing the form with the |
16 | | Registry, but may not prohibit the release of identifying |
17 | | information. All Birth Parent Preference Forms on file with |
18 | | the Registry at the time of receipt of a Request for a |
19 | | Non-Certified Copy of an Original Birth Certificate from an |
20 | | adult adopted or surrendered person or the surviving adult |
21 | | child or surviving spouse of a deceased adopted or |
22 | | surrendered person shall be forwarded to the relevant |
23 | | adopted or surrendered person or surviving adult child or |
24 | | surviving spouse of a deceased adopted or surrendered |
25 | | person along with a non-certified copy of the adopted or |
26 | | surrendered person's original birth certificate as |
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1 | | outlined in subsection (e) of this Section. |
2 | | (e) Procedures for requesting a non-certified copy of an |
3 | | original birth certificate by an adult adopted or surrendered |
4 | | person or by a surviving adult child or surviving spouse of a |
5 | | deceased adopted or surrendered person: |
6 | | (1) On or after the effective date of this amendatory |
7 | | Act of the 96th General Assembly, any adult adopted or |
8 | | surrendered person who was born in Illinois prior to |
9 | | January 1, 1946, may complete and file with the Registry a |
10 | | Request for a Non-Certified Copy of an Original Birth |
11 | | Certificate. The Registry shall provide such adult adopted |
12 | | or surrendered person with an unaltered, non-certified |
13 | | copy of his or her original birth certificate upon receipt |
14 | | of the Request for a Non-Certified Copy of an Original |
15 | | Birth Certificate. Additionally, in cases where an adopted |
16 | | or surrendered person born in Illinois prior to January 1, |
17 | | 1946, is deceased, and one of his or her surviving adult |
18 | | children or his or her surviving spouse has registered with |
19 | | the Registry, he or she may complete and file with the |
20 | | Registry a Request for a Non-Certified Copy of an Original |
21 | | Birth Certificate. The Registry shall provide such |
22 | | surviving adult child or surviving spouse with an |
23 | | unaltered, non-certified copy of the adopted or |
24 | | surrendered person's original birth certificate upon |
25 | | receipt of the Request for a Non-Certified Copy of an |
26 | | Original Birth Certificate. |
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1 | | (2) Beginning November 15, 2011, any adult adopted or |
2 | | surrendered person who was born in Illinois on or after |
3 | | January 1, 1946, may complete and file with the Registry a |
4 | | Request for a Non-certified Copy of an Original Birth |
5 | | Certificate. Additionally, in cases where the adopted or |
6 | | surrendered person is deceased and one of his or her |
7 | | surviving adult children or his or her surviving spouse has |
8 | | registered with the Registry, he or she may complete and |
9 | | file with the Registry a Request for a Non-Certified Copy |
10 | | of an Original Birth Certificate.
Upon receipt of such |
11 | | request from an adult adopted or surrendered person or from |
12 | | one of his or her surviving adult children or his or her |
13 | | surviving spouse, the Registry shall: |
14 | | (i) Determine if there is a Denial of Information |
15 | | Exchange which was filed by a birth parent named on the |
16 | | original birth certificate prior to January 1, 2011. If |
17 | | a Denial was filed by a birth parent named on the |
18 | | original birth certificate prior to January 1, 2011, |
19 | | and there is no proof of death in the Registry file for |
20 | | the birth parent who filed said Denial, the Registry |
21 | | shall inform the requesting adult adopted or |
22 | | surrendered person or the requesting surviving adult |
23 | | child or surviving spouse of a deceased adopted or |
24 | | surrendered person that they may receive a |
25 | | non-certified copy of the original birth certificate |
26 | | from which all identifying information pertaining to |
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1 | | the birth parent who filed the Denial has been |
2 | | redacted. A requesting adult adopted or surrendered |
3 | | person shall also be informed in writing of his or her |
4 | | right to petition the court for the appointment of a |
5 | | confidential intermediary pursuant to Section 18.3a of |
6 | | this Act and, if applicable, to conduct a search |
7 | | through an agency post-adoption search program once 5 |
8 | | years have elapsed since the birth parent filed the |
9 | | Denial of Information Exchange with the Registry. |
10 | | (ii) Determine if a birth parent named on the |
11 | | original birth certificate has filed a Birth Parent |
12 | | Preference Form. If one of the birth parents named on |
13 | | the original birth certificate filed a Birth Parent |
14 | | Preference Form and selected Option A, B, C, or D, the |
15 | | Registry shall forward to the adult adopted or |
16 | | surrendered person or to the surviving adult child or |
17 | | surviving spouse of a deceased adopted or surrendered |
18 | | person a copy of the Birth Parent Preference Form along |
19 | | with an unaltered non-certified copy of his or her |
20 | | original birth certificate .
If one of the birth parents |
21 | | named on the original birth certificate filed a Birth |
22 | | Parent Preference Form and selected Option E, and there |
23 | | is no proof of death in the Registry file for the birth |
24 | | parent who filed said Birth Parent Preference Form, the |
25 | | Registry shall inform the requesting adult adopted or |
26 | | surrendered person or the requesting surviving adult |
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1 | | child or surviving spouse of a deceased adopted or |
2 | | surrendered person that he or she may receive a |
3 | | non-certified copy of the original birth certificate |
4 | | from which identifying information pertaining to the |
5 | | birth parent who completed the Birth Parent Preference |
6 | | Form has been redacted per the birth parent's |
7 | | specifications on the Form. The Registry shall forward |
8 | | to the adult adopted or surrendered person or to the |
9 | | surviving adult child or surviving spouse of a deceased |
10 | | adopted or surrendered person a copy of the Birth |
11 | | Parent Preference Form filed by the birth parent from |
12 | | which identifying information has been redacted per |
13 | | the birth parent's specifications on the Form. The |
14 | | requesting adult adopted or surrendered person shall |
15 | | also be informed in writing of his or her right to |
16 | | petition the court for the appointment of a |
17 | | confidential intermediary pursuant to Section 18.3a of |
18 | | this Act, and, if applicable, to conduct a search |
19 | | through an agency post-adoption search program once 5 |
20 | | years have elapsed since the birth parent filed the |
21 | | Birth Parent Preference Form, on which Option E was |
22 | | selected, with the Registry. |
23 | | (iii) Determine if a birth parent named on the |
24 | | original birth certificate has filed an Information |
25 | | Exchange Authorization. |
26 | | (iv) If the Registry has confirmed that a |
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1 | | requesting adult adopted or surrendered person or the |
2 | | parent of a requesting adult child of a deceased |
3 | | adopted or surrendered person or the husband or wife of |
4 | | a requesting surviving spouse was not the object of a |
5 | | Denial of Information Exchange filed by a birth parent |
6 | | on or before December 31, 2010, and that no birth |
7 | | parent named on the original birth certificate has |
8 | | filed a Birth Parent Preference Form where Option E was |
9 | | selected prior to the receipt of a Request for a |
10 | | Non-Certified Copy of an Original Birth Certificate, |
11 | | the Registry shall provide the adult adopted or |
12 | | surrendered person or his or her surviving adult child |
13 | | or surviving spouse with an unaltered non-certified |
14 | | copy of the adopted or surrendered person's original |
15 | | birth certificate. |
16 | | (3) In cases where the Registry receives a Birth Parent |
17 | | Preference Form from a birth parent subsequent to the |
18 | | release of the non-certified copy of the original birth |
19 | | certificate to an adult adopted or surrendered person or to |
20 | | the surviving adult child or surviving spouse of a deceased |
21 | | adopted or surrendered person, the Birth Parent Preference |
22 | | Form shall be immediately forwarded to the adult adopted or |
23 | | surrendered person or to the surviving adult child or |
24 | | surviving spouse of the deceased adopted or surrendered |
25 | | person and the birth parent who filed the form shall be |
26 | | informed that the relevant original birth certificate has |
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1 | | already been released. |
2 | | (4) A copy of the original birth certificate shall only |
3 | | be released to adopted or surrendered persons who were born |
4 | | in Illinois; to surviving adult children or surviving |
5 | | spouses of deceased adopted or surrendered persons who were |
6 | | born in Illinois; or to 2 registered parties who have both |
7 | | consented to the release of a non-certified copy of the |
8 | | original birth certificate to one another through the |
9 | | Registry when the birth of the relevant adopted or |
10 | | surrendered person took place in Illinois. |
11 | | (5) In cases where the Registry receives a Request for |
12 | | a Non-Certified Copy of an Original Birth Certificate from |
13 | | an adult adopted or surrendered person who has not |
14 | | completed a Registry application and the file of that |
15 | | adopted or surrendered person includes an Information |
16 | | Exchange Authorization , Birth Parent Preference Form, or |
17 | | Medical Information Exchange Questionnaire from one or |
18 | | more of his or her birth relatives, the Registry shall so |
19 | | inform the adult adopted or surrendered person and forward |
20 | | Registry application forms to him or her along with a |
21 | | non-certified copy of the original birth certificate |
22 | | consistent with the procedures outlined in this subsection |
23 | | (e). |
24 | | (6) In cases where a birth parent registered with the |
25 | | Registry and filed a Medical Information Exchange |
26 | | Questionnaire prior to the effective date of this |
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1 | | amendatory Act of the 96th General Assembly but gave no |
2 | | indication as to his or her wishes regarding contact or the |
3 | | sharing of identifying information, the Registry shall |
4 | | contact the birth parent by written letter prior to January |
5 | | 1, 2011, and provide him or her with the opportunity to |
6 | | indicate his or her preference regarding contact and the |
7 | | sharing of identifying information by submitting a Birth |
8 | | Parent Preference Form to the Registry prior to November 1, |
9 | | 2011. |
10 | | (7) In cases where the Registry cannot locate a copy of |
11 | | the original birth certificate in the Registry file, they |
12 | | shall be authorized to request a copy of the original birth |
13 | | certificate from the Illinois county where the birth took |
14 | | place for placement in the Registry file. |
15 | | (8) Adopted and surrendered persons who wish to have |
16 | | their names placed with the Illinois Adoption Registry and |
17 | | Medical Information Exchange may do so by completing a |
18 | | Registry application at any time, but completing a Registry |
19 | | application shall not be required for adopted and |
20 | | surrendered persons who seek only to obtain a copy of their |
21 | | original birth certificate or any relevant Birth Parent |
22 | | Preference Forms through the Registry. |
23 | | (9) In cases where a birth parent filed a Denial of |
24 | | Information Exchange with the Registry prior to January 1, |
25 | | 2011, or filed a Birth Parent Preference Form with the |
26 | | Registry and selected Option E after January 1, 2011, and a |
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1 | | proof of death for the birth parent who filed the Denial or |
2 | | the Birth Parent Preference Form has been filed with the |
3 | | Registry by either a confidential intermediary , or a |
4 | | surviving relative of the deceased birth parent, or a birth |
5 | | child of the deceased birth parent, the Registry shall be |
6 | | authorized to release an unaltered non-certified copy of |
7 | | the original birth certificate to an adult adopted or |
8 | | surrendered person or to the surviving adult child or |
9 | | surviving spouse of a deceased adopted or surrendered |
10 | | person who has filed a Request for a Non-Certified Copy of |
11 | | the Original Birth Certificate with the Registry. |
12 | | (10) On and after the effective date of this amendatory |
13 | | Act of the 96th General Assembly, in cases where all birth |
14 | | parents named on the original birth certificate of an |
15 | | adopted or surrendered person born after January 1, 1946, |
16 | | are deceased and copies of death certificates for all birth |
17 | | parents named on the original birth certificate have been |
18 | | filed with the Registry by either a confidential |
19 | | intermediary , or a surviving relative of the deceased birth |
20 | | parent, or a birth child of the deceased birth parent, the |
21 | | Registry shall be authorized to release a non-certified |
22 | | copy of the original birth certificate to the adopted or |
23 | | surrendered person upon receipt of his or her Request for a |
24 | | Non-Certified Copy of an Original Birth Certificate. |
25 | | (f) A registrant may complete all or any part of the |
26 | | Illinois Adoption
Registry Application. All Illinois Adoption |
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1 | | Registry Applications, Information
Exchange
Authorizations, |
2 | | Denials of Information Exchange, requests to revoke an
|
3 | | Information
Exchange Authorization or Denial of Information |
4 | | Exchange, Birth Parent Preference Forms, and affidavits
|
5 | | submitted
to the Registry shall be
accompanied by proof of |
6 | | identification.
|
7 | | (Source: P.A. 96-895, eff. 5-21-10; revised 9-2-10.)
|
8 | | (750 ILCS 50/18.2) (from Ch. 40, par. 1522.2)
|
9 | | Sec. 18.2. Forms.
|
10 | | (a) The Department shall develop the Illinois Adoption |
11 | | Registry forms as provided in this Section. The General |
12 | | Assembly shall reexamine the content of the form as requested |
13 | | by the Department, in consultation with the Registry Advisory |
14 | | Council. The form of the Birth Parent Registration
|
15 | | Identification Form shall be substantially as follows:
|
16 | | BIRTH PARENT REGISTRATION IDENTIFICATION
|
17 | | (Insert all known information)
|
18 | | I, ....., state that I am the ...... (mother or father) of the
|
19 | | following child:
|
20 | | Child's original name: ..... (first) ..... (middle) ..... |
21 | | (last),
..... (hour of birth), ..... (date of birth), |
22 | | ..... (city and state of
birth), ..... (name of |
23 | | hospital).
|
24 | | Father's full name: ...... (first) ...... (middle) ..... |
25 | | (last),
..... (date of birth), ..... (city and state of |
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1 | | birth).
|
2 | | Name of mother inserted on birth certificate: ..... (first) |
3 | | .....
(middle) ..... (last), ..... (race), ..... (date |
4 | | of birth), ......
(city and state of birth).
|
5 | | That I surrendered my child to: ............. (name of agency), |
6 | | .....
(city and state of agency), ..... (approximate date |
7 | | child surrendered).
|
8 | | That I placed my child by private adoption: ..... (date),
|
9 | | ...... (city
and state).
|
10 | | Name of adoptive parents, if known: ......
|
11 | | Other identifying information: .....
|
12 | | ........................
|
13 | | (Signature of parent)
|
14 | | ............ ........................
|
15 | | (date) (printed name of parent)
|
16 | | (b) The form of the Adopted Person
Registration |
17 | | Identification shall be substantially
as follows:
|
18 | | ADOPTED PERSON
|
19 | | REGISTRATION IDENTIFICATION
|
20 | | (Insert all known information)
|
21 | | I, ....., state the following:
|
22 | | Adopted Person's present name: ..... (first) ..... |
23 | | (middle)
..... (last).
|
24 | | Adopted Person's name at birth (if known): ..... (first)
|
25 | | ..... (middle) .....
(last), ..... (birth date), ..... |
|
| | 09600HB1445ham002 | - 36 - | LRB096 05030 AJO 44197 a |
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|
1 | | (city and state of birth), ......
(sex), ..... (race).
|
2 | | Name of adoptive father: ..... (first) ..... (middle) ..... |
3 | | (last), .....
(race).
|
4 | | Maiden name of adoptive mother: ..... (first) ..... |
5 | | (middle) .....
(last), ..... (race).
|
6 | | Name of birth mother (if known): ..... (first) .....
|
7 | | (middle)
..... (last), ..... (race).
|
8 | | Name of birth father (if known): ..... (first) .....
|
9 | | (middle)
..... (last), ..... (race).
|
10 | | Name(s) at birth of sibling(s) having a common birth
parent |
11 | | with adoptee
(if known): ..... (first) ..... (middle) |
12 | | ..... (last), ..... (race), and name
of common birth |
13 | | parent: ..... (first) ..... (middle) .....
(last),
|
14 | | ..... (race).
|
15 | | I was adopted through: ..... (name of agency).
|
16 | | I was adopted privately: ..... (state "yes" if known).
|
17 | | I was adopted in ..... (city and state), ..... (approximate |
18 | | date).
|
19 | | Other identifying information: .............
|
20 | | ......................
|
21 | | (signature of adoptee)
|
22 | | ........... .........................
|
23 | | (date) (printed name of adoptee)
|
24 | | (c) The form of the Surrendered Person Registration |
25 | | Identification shall be
substantially as follows:
|
|
| | 09600HB1445ham002 | - 37 - | LRB096 05030 AJO 44197 a |
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|
1 | | SURRENDERED PERSON REGISTRATION
|
2 | | IDENTIFICATION
|
3 | | (Insert all known information)
|
4 | | I, ....., state the following:
|
5 | | Surrendered Person's present name: ..... (first) .....
|
6 | | (middle) ..... (last).
|
7 | | Surrendered Person's name at birth (if known): ..... |
8 | | (first)
.....
(middle) ..... (last), .....(birth |
9 | | date), ..... (city and state of
birth), ...... (sex), |
10 | | ..... (race).
|
11 | | Name of guardian father: ..... (first) ..... (middle) ..... |
12 | | (last), .....
(race).
|
13 | | Maiden name of guardian mother: ..... (first) ..... |
14 | | (middle) .....
(last), ..... (race).
|
15 | | Name of birth mother (if known): ..... (first) .....
|
16 | | (middle) .....
(last) ..... (race).
|
17 | | Name of birth father (if known): ..... (first) .....
|
18 | | (middle) .....
(last), .....(race).
|
19 | | Name(s) at birth of sibling(s) having a common birth
parent |
20 | | with surrendered person
(if known): ..... (first) |
21 | | ..... (middle) ..... (last), ..... (race), and name
of |
22 | | common birth parent: ..... (first) ..... (middle) |
23 | | .....
(last),
..... (race).
|
24 | | I was surrendered for adoption to: ..... (name of agency).
|
25 | | I was surrendered for adoption in ..... (city and state), ..... |
26 | | (approximate
date).
|
|
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|
1 | | Other identifying information: ............
|
2 | | ................................
|
3 | | (signature of surrendered person)
|
4 | | ............ ......................
|
5 | | (date) (printed name of person
|
6 | | surrendered for adoption)
|
7 | | (c-3) The form of the Registration Identification Form for |
8 | | Surviving Relatives of Deceased Birth Parents shall be |
9 | | substantially as follows:
|
10 | | REGISTRATION IDENTIFICATION FORM
|
11 | | FOR SURVIVING RELATIVES OF DECEASED BIRTH PARENTS
|
12 | | (Insert all known information)
|
13 | | I, ....., state the following:
|
14 | | Name of deceased birth parent at time of surrender:
|
15 | | Deceased birth parent's date of birth:
|
16 | | Deceased birth parent's date of death:
|
17 | | Adopted or surrendered person's name at birth (if known): |
18 | | .....(first) ..... (middle) ..... (last), .....(birth |
19 | | date), ..... (city and state of birth), ...... (sex), |
20 | | ..... (race).
|
21 | | My relationship to the adopted or surrendered person (check |
22 | | one): (birth parent's non-surrendered child) (birth parent's |
23 | | sister) (birth parent's brother).
|
24 | | If you are a non-surrendered child of the birth parent, provide |
|
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1 | | name(s) at birth and age(s) of non-surrendered siblings having |
2 | | a common parent with the birth parent. If more than one |
3 | | sibling, please give information requested below on reverse |
4 | | side of this form. If you are a sibling or parent of the birth |
5 | | parent, provide name(s) at birth and age(s) of the sibling(s) |
6 | | of the birth parent. If more than one sibling, please give |
7 | | information requested below on reverse side of this form.
|
8 | | Name (First) ..... (middle) ..... (last), .....(birth |
9 | | date), ..... (city and state of birth), ...... (sex), |
10 | | ..... (race).
|
11 | | Name(s) of common parent(s) (first) ..... (middle) ..... |
12 | | (last), .....(race), (first) ..... (middle) ..... |
13 | | (last), .....(race).
|
14 | | My birth sibling/child of my brother/child of my sister/ was |
15 | | surrendered for adoption to ..... (name of agency) City and |
16 | | state of agency ..... Date .....(approximate) Other |
17 | | identifying information ..... (Please note that you must: (i) |
18 | | be at least 21 years of age to register; (ii) submit with your |
19 | | registration a certified copy of the birth parent's birth |
20 | | certificate; (iii) submit a certified copy of the birth |
21 | | parent's death certificate; and (iv) if you are a |
22 | | non-surrendered birth sibling or a sibling of the deceased |
23 | | birth parent, also submit a certified copy of your birth |
24 | | certificate with this registration. No application from a |
25 | | surviving relative of a deceased birth parent can be accepted |
26 | | if the birth parent filed a Denial of Information Exchange |
|
| | 09600HB1445ham002 | - 40 - | LRB096 05030 AJO 44197 a |
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|
1 | | prior to his or her death.)
|
2 | | ................................
|
3 | | (signature of birth parent's surviving relative)
|
4 | | ............ ............ |
5 | | (date) (printed name of birth |
6 | | parent's surviving relative) |
7 | | (c-5) The form of the Registration Identification Form for |
8 | | Surviving Relatives of Deceased Adopted or Surrendered Persons |
9 | | shall be substantially as follows:
|
10 | | REGISTRATION IDENTIFICATION FORM FOR
|
11 | | SURVIVING RELATIVES OF DECEASED ADOPTED OR SURRENDERED PERSONS
|
12 | | (Insert all known information)
|
13 | | I, ....., state the following:
|
14 | | Adopted or surrendered person's name at birth (if known): |
15 | | (first) ..... (middle) ..... (last), .....(birth |
16 | | date), ..... (city and state of birth), ...... (sex), |
17 | | ..... (race). |
18 | | Adopted or surrendered person's date of death:
|
19 | | My relationship to the deceased adopted or surrendered |
20 | | person(check one): (adoptive mother) (adoptive father) (adult |
21 | | child) (surviving spouse).
|
22 | | If you are an adult child or surviving spouse of the adopted or |
23 | | surrendered person, provide name(s) at birth and age(s) of the |
24 | | children of the adopted or surrendered person. If the adopted |
|
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1 | | or surrendered person had more than one child, please give |
2 | | information requested below on reverse side of this form. |
3 | | Name (first) ..... (middle) ..... (last), .....(birth |
4 | | date), ..... (city and state of birth), ...... (sex), |
5 | | ..... (race). |
6 | | Name(s) of common parent(s) (first) ..... (middle) ..... |
7 | | (last), .....(race), (first) ..... (middle) ..... |
8 | | (last), .....(race).
|
9 | | My child/parent/deceased spouse was surrendered for |
10 | | adoption to .....(name of agency) City and state of agency |
11 | | ..... Date ..... (approximate) Other identifying |
12 | | information ..... (Please note that you must: (i) be at |
13 | | least 21 years of age to register; (ii) submit with your |
14 | | registration a certified copy of the adopted or surrendered |
15 | | person's death certificate; (iii) if you are the child of a |
16 | | deceased adopted or surrendered person, also submit a |
17 | | certified copy of your birth certificate with this |
18 | | registration; and (iv) if you are the surviving wife or |
19 | | husband of a deceased adopted or surrendered person, also |
20 | | submit a copy of your marriage certificate with this |
21 | | registration. No application from a surviving relative of a |
22 | | deceased adopted or surrendered person can be accepted if |
23 | | the adopted or surrendered person filed a Denial of |
24 | | Information Exchange prior to his or her death.)
|
25 | | ................................
|
26 | | (signature of adopted or surrendered person's surviving
|
|
| | 09600HB1445ham002 | - 42 - | LRB096 05030 AJO 44197 a |
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|
1 | | relative)
|
2 | | ............ ............ |
3 | | (date) (printed name of adopted
|
4 | | person's surviving relative)
|
5 | | (d) The form of the Information Exchange Authorization |
6 | | shall be
substantially
as follows:
|
7 | | INFORMATION EXCHANGE AUTHORIZATION
|
8 | | I, ....., state that I am the person who completed the |
9 | | Registration
Identification; that I am of the age of ..... |
10 | | years; that I hereby
authorize the Department of Public Health |
11 | | to give to the following person(s)
(birth mother
)
(birth |
12 | | father) (birth sibling) (adopted or surrendered person
) |
13 | | (adoptive mother) (adoptive father) (legal guardian of an |
14 | | adopted or surrendered person) (birth aunt) (birth uncle) |
15 | | (adult child of a deceased adopted or surrendered person) |
16 | | (surviving spouse of a deceased adopted or surrendered person) |
17 | | (all eligible relatives) the following
(please check the
|
18 | | information
authorized for exchange):
|
19 | | [ ] 1. Only my name and last known address.
|
20 | | [ ] 2. A copy of my Illinois Adoption Registry |
21 | | Application.
|
22 | | [ ] 3. A non-certified copy of the adopted or |
23 | | surrendered person's original certificate of live birth |
|
| | 09600HB1445ham002 | - 43 - | LRB096 05030 AJO 44197 a |
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|
1 | | (check only if you are an adopted or surrendered person or |
2 | | the surviving adult child or surviving spouse of a deceased |
3 | | adopted or surrendered person).
|
4 | | [ ] 4. A copy of my completed medical questionnaire.
|
5 | | I am fully aware that I can only be supplied with
|
6 | | information about an individual or individuals who have
duly
|
7 | | executed an Information Exchange Authorization that
has
not |
8 | | been revoked or, if I am an adopted or surrendered person, from |
9 | | a birth parent who completed a Birth Parent Preference Form and |
10 | | did not prohibit the release of his or her identity to me; that |
11 | | I can be contacted by writing to: ..... (own name or
name of |
12 | | person to contact) (address) (phone number).
|
13 | | NOTE: New IARMIE registrants who do not complete a Medical |
14 | | Information Exchange Questionnaire and release a copy of their |
15 | | questionnaire to at least one Registry applicant must pay a $15 |
16 | | registration fee. |
17 | | Dated (insert date).
|
18 | | .............. |
19 | | (signature)
|
20 | | (e) The form of the Denial of Information Exchange shall be
|
21 | | substantially as follows:
|
22 | | DENIAL OF INFORMATION EXCHANGE
|
23 | | I, ....., state that I am the person who completed the |
24 | | Registration
Identification; that I am of the age of ..... |
25 | | years; that I hereby
instruct the Department of Public Health |
|
| | 09600HB1445ham002 | - 44 - | LRB096 05030 AJO 44197 a |
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|
1 | | not to give any identifying
information about me to the |
2 | | following person(s)
(birth mother) (birth father) (birth |
3 | | sibling)(adopted or surrendered person)(adoptive mother) |
4 | | (adoptive father)(legal guardian of an adopted or surrendered |
5 | | person)(birth aunt)(birth uncle)(adult child of a deceased |
6 | | adopted or surrendered person) (surviving spouse of a deceased |
7 | | adopted or surrendered person) (all eligible relatives). |
8 | | IMPORTANT NOTE: A DENIAL FILED BY A BIRTH PARENT ON OR AFTER |
9 | | JANUARY 1, 2011, SHALL NOT PROHIBIT THE RELEASE OF THE BIRTH |
10 | | PARENT'S IDENTIFYING INFORMATION ON THE ORIGINAL BIRTH |
11 | | CERTIFICATE OF AN ADULT ADOPTED OR SURRENDERED PERSON. BIRTH |
12 | | PARENTS WHO WISH TO PROHIBIT THE RELEASE OF THEIR IDENTIFYING |
13 | | INFORMATION ON THE ORIGINAL BIRTH CERTIFICATE OF AN ADULT |
14 | | ADOPTED OR SURRENDERED PERSON SHALL FILE A BIRTH PARENT |
15 | | PREFERENCE FORM ON OR AFTER JANUARY 1, 2011. DENIALS FILED BY A |
16 | | BIRTH PARENT BEFORE JANUARY 1, 2011, WILL EXPIRE UPON THE DEATH |
17 | | OF THE BIRTH PARENT WITH RESPECT TO ACCESS TO IDENTIFYING |
18 | | INFORMATION ON THE ORIGINAL BIRTH CERTIFICATE RELEASED TO AN |
19 | | ADULT ADOPTED OR SURRENDERED PERSON OR TO A SURVIVING ADULT |
20 | | CHILD OR SURVIVING SPOUSE OF A DECEASED ADOPTED OR SURRENDERED |
21 | | PERSON.
|
22 | | I do/do not (circle appropriate response) authorize the |
23 | | Registry to release a copy of my completed Medical Information |
24 | | Exchange Questionnaire to qualified Registry applicants.
NOTE: |
25 | | New IARMIE registrants who do not complete a Medical |
26 | | Information Exchange Questionnaire and release a copy of their |
|
| | 09600HB1445ham002 | - 45 - | LRB096 05030 AJO 44197 a |
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|
1 | | questionnaire to at least one Registry applicant must pay a $15 |
2 | | registration fee.
Birth parents filing a Denial of Information |
3 | | Exchange are advised that, under Illinois law, an adult adopted |
4 | | person may initiate a search for a birth parent who has filed a |
5 | | Denial of Information Exchange or Birth Parent Preference Form |
6 | | on which Option E was selected through the State confidential |
7 | | intermediary program once 5 years have elapsed since the filing |
8 | | of the Denial of Information Exchange or Birth Parent |
9 | | Preference Form .
|
10 | | Dated (insert date).
|
11 | | ............... |
12 | | (signature)
|
13 | | (f) The form of the Birth Parent Preference Form shall be |
14 | | substantially as follows: |
15 | | In recognition of the basic right of all persons to access |
16 | | their birth records, Illinois law now provides for the release |
17 | | of original birth certificates to adopted and surrendered |
18 | | persons 21 years of age or older upon request. While many birth |
19 | | parents are comfortable sharing their identities or initiating |
20 | | contact with their birth sons and daughters once they have |
21 | | reached adulthood, Illinois law also recognizes that there may |
22 | | be unique situations where a birth parent might have a |
23 | | compelling reason for not wishing to establish contact with a |
24 | | birth son or birth daughter or for not wishing to release |
25 | | identifying information that appears on the original birth |
|
| | 09600HB1445ham002 | - 46 - | LRB096 05030 AJO 44197 a |
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1 | | certificate of a birth son or birth daughter who has reached |
2 | | adulthood. The Illinois Adoption Registry and Medical |
3 | | Information Exchange (IARMIE) has therefore established the |
4 | | attached this form to allow birth parents whose birth son or |
5 | | daughter was born on or after January 1, 1946, to express their |
6 | | preferences wishes regarding contact ; and , if their birth child |
7 | | was born on or after January 1, 1946, to express their wishes |
8 | | regarding the sharing of identifying information listed on the |
9 | | original birth certificate with an adult adopted or surrendered |
10 | | person who has reached the age of 21 or his or her surviving |
11 | | relatives . |
12 | | In selecting one of the 5 options below, birth parents |
13 | | should keep in mind that the decision to deny an adult adopted |
14 | | or surrendered person access to identifying information on his |
15 | | or her original birth record and/or information about |
16 | | genetically-transmitted diseases is an important decision one |
17 | | that may can impact the adopted or surrendered person's life in |
18 | | many ways. A request for anonymity on this form only pertains |
19 | | to information that is provided to an adult adopted or |
20 | | surrendered person or his or her surviving relatives through |
21 | | the Registry . This will and does not prevent the disclosure of |
22 | | identifying information that may be available to the adoptee |
23 | | through his or her adoptive parents and/or other means |
24 | | available to him or her. Birth parents who would prefer not to |
25 | | be contacted by their surrendered son or daughter are strongly |
26 | | urged to complete both the Non-Identifying Information Section |
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| | 09600HB1445ham002 | - 47 - | LRB096 05030 AJO 44197 a |
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1 | | included on the final page of the attached form this document |
2 | | and the Medical Questionnaire in order to provide their |
3 | | surrendered son or daughter with the background information he |
4 | | or she their surrendered son or daughter may need to better |
5 | | understand himself or herself and his or her origins. Birth |
6 | | parents whose birth son or birth daughter is under 21 years of |
7 | | age at the time of the completion of this form are reminded |
8 | | that no original birth certificate will be released by the |
9 | | IARMIE before an adoptee his reached the age of 21. |
10 | | Furthermore, birth parents whose surrendered son or daughter is |
11 | | under 21 years of age at the time of completion of this form |
12 | | are reminded that, since no original birth certificates are |
13 | | released by the IARMIE before an adoptee has reached the age of |
14 | | 21, and birth parents are encouraged to take as much time as |
15 | | they need to weigh the options available to them before |
16 | | completing this form. Should you need additional assistance in |
17 | | completing this form, please contact the agency that handled |
18 | | the adoption, if applicable, or the Illinois Adoption Registry |
19 | | and Medical Information Exchange at 877-323-5299 217-557-5159 . |
20 | | After careful consideration, I , (insert your name) ......, |
21 | | have made the following decision regarding contact with my |
22 | | birth son/birth daughter, (insert birth son's/birth daughter's |
23 | | name at birth, if applicable) ......, who was born in (insert |
24 | | city/town of birth) ...... on (insert date of birth)...... and |
25 | | the release of my identifying information as it appears on |
26 | | his/her original birth certificate when he/she reaches the age |
|
| | 09600HB1445ham002 | - 48 - | LRB096 05030 AJO 44197 a |
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1 | | of 21, and I have chosen Option ...... (insert A, B, C, D, or E, |
2 | | as applicable). I realize that this form must be accompanied by |
3 | | a completed IARMIE application form as well as a Medical |
4 | | Information Exchange Questionnaire or the $15 registration |
5 | | fee. I am also aware that I may revoke this decision at any |
6 | | time by completing a new Birth Parent Preference Form and |
7 | | filing it with the IARMIE. I understand that it is my |
8 | | responsibility to update the IARMIE with any changes to contact |
9 | | information provided below. I also understand that, while |
10 | | preferences regarding the release of identifying information |
11 | | through the Registry are binding unless the law should change |
12 | | in the future, any selection I have made regarding my preferred |
13 | | method of contact is not. |
14 | | .................................... |
15 | | (Signature/Date) |
16 | | (Please insert your signature and today's date above, as well |
17 | | as under your chosen option, A, B, C, D, or E below.) |
18 | | Option A. My birth son or birth daughter was born on or after |
19 | | January 1, 1946, and I agree to the release of my identifying |
20 | | information as it appears on my birth son's/birth daughter's |
21 | | original birth certificate, OR my birth son or birth daughter |
22 | | was born prior to January 1, 1946. I would welcome direct |
23 | | contact with my birth son/birth daughter when he or she has |
24 | | reached the age of 21 . In addition, before my birth son or |
|
| | 09600HB1445ham002 | - 49 - | LRB096 05030 AJO 44197 a |
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|
1 | | birth daughter has reached the age of 21 or in the event of his |
2 | | or her death, I would welcome contact with the following |
3 | | relatives of my birth child (circle all that apply): adoptive |
4 | | mother, adoptive father, surviving spouse, surviving adult |
5 | | child. and I wish to be contacted at the following mailing |
6 | | address, email address or phone number: |
7 | | ..................... |
8 | | ............................................................. |
9 | | ............................................................. |
10 | | ............................................................. |
11 | | (Signature/Date) |
12 | | Option B. My birth son or birth daughter was born on or after |
13 | | January 1, 1946, and I agree to the release of my identifying |
14 | | information as it appears on my birth son's/birth daughter's |
15 | | original birth certificate, OR my birth son or birth daughter |
16 | | was born prior to January 1, 1946. I would welcome contact with |
17 | | my birth son/birth daughter when he or she has reached the age |
18 | | of 21 . In addition, before my birth son or birth daughter has |
19 | | reached the age of 21 or in the event of his or her death, I |
20 | | would welcome contact with the following relatives of my birth |
21 | | child (circle all that apply): adoptive mother, adoptive |
22 | | father, surviving spouse, surviving adult child. , but I would |
23 | | prefer to be contacted through the following person. (Insert |
24 | | name and mailing address, email address or phone number of |
25 | | chosen contact person.) |
|
| | 09600HB1445ham002 | - 50 - | LRB096 05030 AJO 44197 a |
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|
1 | | ..................................... |
2 | | ............................................................. |
3 | | (Signature/Date) |
4 | | Option C. My birth son or birth daughter was born on or after |
5 | | January 1, 1946, and I agree to the release of my identifying |
6 | | information name as it appears on my birth son's/birth |
7 | | daughter's original birth certificate, OR my birth son or birth |
8 | | daughter was born prior to January 1, 1946. I would welcome |
9 | | contact with my birth son/birth daughter when he or she has |
10 | | reached the age of 21 . In addition, before my birth son or |
11 | | birth daughter has reached the age of 21 or in the event of his |
12 | | or her death, I would welcome contact with the following |
13 | | relatives of my birth child (circle all that apply): adoptive |
14 | | mother, adoptive father, surviving spouse, surviving adult |
15 | | child. , but I would prefer to be contacted through the |
16 | | Illinois Confidential Intermediary Program confidential |
17 | | intermediary program (please call 800-526-9022 for additional |
18 | | information) or through the agency that handled the adoption. |
19 | | (Insert agency name, address and phone number, if applicable.) |
20 | | . |
21 | | ............................................................. |
22 | | (Signature/Date) |
23 | | Option D. My birth son or birth daughter was born on or after |
24 | | January 1, 1946, and I agree to the release of my identifying |
|
| | 09600HB1445ham002 | - 51 - | LRB096 05030 AJO 44197 a |
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|
1 | | information name as it appears on my birth son's/birth |
2 | | daughter's original birth certificate when he or she has |
3 | | reached the age of 21 , OR my birth son or birth daughter was |
4 | | born prior to January 1, 1946. but I would prefer not to be |
5 | | contacted by my birth son/birth daughter or his or her adoptive |
6 | | parents or surviving relatives when he or she has reached the |
7 | | age of 21 . |
8 | | ................... |
9 | | (Signature/Date) |
10 | | Option E. My birth son or birth daughter was born on or after |
11 | | January 1, 1946, and I wish to prohibit the release of my |
12 | | (circle ALL applicable options) first name, last name, last |
13 | | known address, birth son/birth daughter's last name (if last |
14 | | name listed is same as mine), as they appear on my birth |
15 | | son's/birth daughter's original birth certificate and do not |
16 | | wish to be contacted by my birth son/birth daughter when he or |
17 | | she has reached the age of 21. If there were any special |
18 | | circumstances that played a role in your decision to remain |
19 | | anonymous which you would like to share with your birth |
20 | | son/birth daughter, please list them in the space provided |
21 | | below (optional). |
22 | | ........................................... |
23 | | ............................................................. |
24 | | I understand that, although I have chosen to prohibit the |
25 | | release of my identity on the non-certified copy of the |
|
| | 09600HB1445ham002 | - 52 - | LRB096 05030 AJO 44197 a |
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|
1 | | original birth certificate released to my birth son/birth |
2 | | daughter, he or she may request that a court-appointed |
3 | | confidential intermediary contact me to request updated |
4 | | medical information and/or confirm my desire to remain |
5 | | anonymous once 5 years have elapsed since the signing of this |
6 | | form; at the time of this subsequent search, I wish to be |
7 | | contacted through the person named below. (Insert in blank area |
8 | | below the name and phone number of the contact person, or leave |
9 | | it blank if you wish to be contacted directly.) I also |
10 | | understand that this request for anonymity shall expire upon my |
11 | | death. |
12 | | ...................................................... |
13 | | ............................................................. |
14 | | (Signature/Date) |
15 | | NOTE: A copy of this form will be forwarded to your birth son |
16 | | or birth daughter should he or she file a request for his or |
17 | | her original birth certificate with the IARMIE. However, if you |
18 | | have selected Option E, identifying information, per your |
19 | | specifications above, will be deleted from the copy of this |
20 | | form forwarded to your birth son or daughter during your |
21 | | lifetime. In the event that an adopted or surrendered person is |
22 | | deceased, his or her surviving adult children may request a |
23 | | copy of the adopted or surrendered person's original birth |
24 | | certificate providing they have registered with the IARMIE; the |
25 | | copy of this form and the non-certified copy of the original |
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1 | | birth certificate forwarded to the surviving child of the |
2 | | adopted or surrendered person shall be redacted per your |
3 | | specifications on this form during your lifetime. |
4 | | Non-Identifying Information Section
|
5 | | I wish to voluntarily provide the following non-identifying |
6 | | information to my birth son or birth daughter surrendered son |
7 | | or daughter :
|
8 | | My age at the time of my child's birth was .........
|
9 | | My race is best described as: .......................... |
10 | | My height is: ......... |
11 | | My body type is best described as (circle one): slim, average, |
12 | | muscular, a few extra pounds, or more than a few extra pounds.
|
13 | | My natural hair color is/was: .................. |
14 | | My eye color is: .................. |
15 | | My religion is best described as: ..................
|
16 | | My ethnic background is best described as: ..................
|
17 | | My educational level is closest to (circle applicable |
18 | | response): completed elementary school, graduated from |
19 | | high school, attended college, earned bachelor's degree, |
20 | | earned master's degree, earned doctoral degree.
|
21 | | My occupation is best described as .................. |
22 | | My hobbies include .................. |
23 | | My interests include .................. |
24 | | My talents include .................. |
25 | | In addition to my surrendered son or daughter, I also |
26 | | am the biological parent of (insert number) ....... boys and |
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1 | | (insert number) ....... girls, of whom (insert number) ....... |
2 | | are still living.
|
3 | | The relationship between me and my child's birth mother/birth |
4 | | father would best be described as (circle appropriate |
5 | | response): husband and wife, ex-spouses, boyfriend and |
6 | | girlfriend, casual acquaintances, other (please specify) |
7 | | .............. |
8 | | (g) The form of the Request for a Non-Certified Copy of an |
9 | | Original Birth Certificate shall be substantially as follows: |
10 | | REQUEST FOR A NON-CERTIFIED COPY OF AN ORIGINAL BIRTH |
11 | | CERTIFICATE |
12 | | I, (requesting party's full name) ....., hereby request a |
13 | | non-certified copy of (check appropriate option) ..... my |
14 | | original birth certificate ..... the original birth |
15 | | certificate of my deceased adopted or surrendered parent ..... |
16 | | the original birth certificate of my deceased adopted or |
17 | | surrendered spouse (insert deceased parent's/deceased spouse's |
18 | | name at adoption) ...... I/my deceased parent/my deceased |
19 | | spouse was born in (insert city and county of adopted or |
20 | | surrendered person's birth) ..... on ..... (insert adopted or |
21 | | surrendered person's date of birth). In the event that one or |
22 | | both of my/my deceased parent's/my deceased spouse's birth |
23 | | parents has requested that their identity not be released to |
24 | | me/to my deceased parent/to my deceased spouse, I wish to |
25 | | (check appropriate option) ..... a. receive a non-certified |
26 | | copy of the original birth certificate from which identifying |
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1 | | information pertaining to the birth parent who requested |
2 | | anonymity has been deleted; or ..... b. I do not wish to |
3 | | received an altered copy of the original birth certificate. |
4 | | Dated (insert date). |
5 | | ................... |
6 | | (signature)
|
7 | | (h) Any Information Exchange Authorization, Denial of |
8 | | Information
Exchange, or Birth Parent Preference Form filed |
9 | | with the Registry, or Request for a Non-Certified Copy of an |
10 | | Original Birth Certificate filed with the Registry by a |
11 | | surviving adult child or surviving spouse of a deceased adopted |
12 | | or surrendered person, shall be acknowledged by the person who |
13 | | filed it before a notary
public, in form
substantially as |
14 | | follows:
|
15 | | State of ..............
|
16 | | County of .............
|
17 | | I, a Notary Public, in and for the said County, in the |
18 | | State aforesaid,
do hereby certify that ............... |
19 | | personally known to me to be the
same person whose name is |
20 | | subscribed to the foregoing certificate of
acknowledgement, |
21 | | appeared before me in person and acknowledged that (he or
she) |
22 | | signed such certificate as (his or her) free and voluntary act |
23 | | and
that the statements in such certificate are true.
|
24 | | Given under my hand and notarial seal on (insert date).
|
25 | | .........................
|
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1 | | (signature)
|
2 | | (i) When the execution of an Information Exchange
|
3 | | Authorization, Denial of Information Exchange, or Birth Parent |
4 | | Preference Form or Request for a Non-Certified Copy of an |
5 | | Original Birth Certificate completed by a surviving adult child |
6 | | or surviving spouse of a deceased adopted or surrendered person |
7 | | is acknowledged before a
representative of an agency, such |
8 | | representative shall have his signature
on said Certificate |
9 | | acknowledged before a notary public, in form substantially
as |
10 | | follows:
|
11 | | State of..........
|
12 | | County of.........
|
13 | | I, a Notary Public, in and for the said County, in the |
14 | | State aforesaid,
do hereby certify that ..... personally known |
15 | | to me to be the same person
whose name is subscribed to the |
16 | | foregoing certificate of acknowledgement,
appeared before me |
17 | | in person and acknowledged that (he or she) signed such
|
18 | | certificate as (his or her) free and voluntary act and that the |
19 | | statements
in such certificate are true.
|
20 | | Given under my hand and notarial seal on (insert date).
|
21 | | .......................
|
22 | | (signature)
|
23 | | (j) When an Illinois Adoption Registry Application,
|
24 | | Information
Exchange Authorization, Denial of
Information |
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1 | | Exchange, Birth Parent Preference Form, or Request for a |
2 | | Non-Certified Copy of an Original Birth Certificate completed |
3 | | by a surviving adult child or surviving spouse of a deceased |
4 | | adopted or surrendered person is executed in a foreign country, |
5 | | the
execution of such
document shall be acknowledged or |
6 | | affirmed before an officer of the United
States consular |
7 | | services.
|
8 | | (k) If the person signing an Information Exchange
|
9 | | Authorization, Denial of Information, Birth Parent Preference |
10 | | Form, or Request for a Non-Certified Copy of an Original Birth |
11 | | Certificate completed by a surviving adult child or surviving |
12 | | spouse of a deceased adopted or surrendered person is in the |
13 | | military service of the
United States, the execution of such |
14 | | document may be acknowledged before a
commissioned officer and |
15 | | the signature of such officer on such certificate
shall be |
16 | | verified or acknowledged before a notary public or by such |
17 | | other
procedure as is then in effect for such division or |
18 | | branch of the armed forces.
|
19 | | (l) An adopted or surrendered person who completes a |
20 | | Request For a Non-Certified Copy of the Original Birth |
21 | | Certificate shall meet the same filing requirements and pay the |
22 | | same filing fees as a non-adopted person seeking to obtain a |
23 | | copy of his or her original birth certificate.
|
24 | | (Source: P.A. 96-895, eff. 5-21-10.)
|
25 | | (750 ILCS 50/18.3a) (from Ch. 40, par. 1522.3a)
|
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1 | | Sec. 18.3a. Confidential intermediary.
|
2 | | (a) General purposes.
Notwithstanding any other provision |
3 | | of
this Act, any
adopted or surrendered person 21 years of age |
4 | | or over, any adoptive parent or legal guardian
of
an adopted or |
5 | | surrendered person under the age of 21, or any birth parent of |
6 | | an adopted
or surrendered person who is 21 years of age or over |
7 | | may petition the court in any county in
the
State of Illinois |
8 | | for appointment of a confidential intermediary as provided in
|
9 | | this Section for the purpose of exchanging medical information |
10 | | with one or
more mutually consenting biological relatives, |
11 | | obtaining identifying
information about one or more mutually |
12 | | consenting biological relatives, or
arranging contact with one |
13 | | or more mutually consenting biological relatives.
|
14 | | Additionally, in cases where an adopted or surrendered person |
15 | | is deceased,
an adult child of the adopted
or surrendered |
16 | | person or his or her adoptive parents or surviving spouse may |
17 | | file a petition under this Section and in cases
where the birth |
18 | | parent is deceased,
an adult birth sibling of the adopted or |
19 | | surrendered person or of the deceased birth parent
may
file a |
20 | | petition under this Section for the purpose of exchanging |
21 | | medical
information with one or more mutually consenting |
22 | | biological relatives of the adopted or surrendered person,
|
23 | | obtaining identifying information about one or more mutually |
24 | | consenting
biological relatives of the adopted or surrendered |
25 | | person, or arranging contact with one or more mutually
|
26 | | consenting biological relatives of the adopted or surrendered |
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1 | | person. Beginning January 1, 2006, any adopted or surrendered |
2 | | person 21 years of age or over; any adoptive parent or legal |
3 | | guardian of an adopted or surrendered person under the age of |
4 | | 21; any birth parent, birth sibling, birth aunt, or birth uncle |
5 | | of an adopted or surrendered person over the age of 21; any |
6 | | surviving child, adoptive parent, or surviving spouse of a |
7 | | deceased adopted or surrendered person who wishes to petition |
8 | | the court for the appointment of a confidential intermediary |
9 | | shall be required to accompany their petition with proof of |
10 | | registration with the Illinois Adoption Registry and Medical |
11 | | Information Exchange.
|
12 | | (b) Petition. Upon petition by an adopted or surrendered
|
13 | | person 21 years of age or over (an "adult adopted or |
14 | | surrendered person"), an
adoptive parent or legal guardian of |
15 | | an adopted or surrendered person under the age of 21,
or a |
16 | | birth parent of an adopted or surrendered person who is 21 |
17 | | years of age or over, the
court
shall appoint a confidential |
18 | | intermediary. Upon petition by
an adult child, adoptive parent |
19 | | or surviving spouse of an adopted or surrendered person who is |
20 | | deceased, by an adult birth sibling of an adopted or |
21 | | surrendered person
whose common birth parent is deceased
and |
22 | | whose adopted or surrendered birth sibling is 21 years of age |
23 | | or over, or by an adult sibling of a birth parent who is |
24 | | deceased,
and whose surrendered child is 21 years of age or |
25 | | over, the court may appoint a confidential
intermediary if the |
26 | | court finds that the disclosure is of greater benefit than
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1 | | nondisclosure.
The petition shall state which biological |
2 | | relative
or
relatives are being sought and shall indicate if |
3 | | the petitioner wants to do any
one or more of the following: |
4 | | exchange medical information with the
biological relative or |
5 | | relatives, obtain identifying information from the
biological |
6 | | relative or relatives, or to arrange contact with the |
7 | | biological
relative.
|
8 | | (c) Order. The order appointing the confidential |
9 | | intermediary shall allow
that
intermediary to conduct a search |
10 | | for the sought-after relative by accessing
those records |
11 | | described in subsection (g) of this Section.
|
12 | | (d) Fees and expenses. The court shall condition the |
13 | | appointment of the
confidential intermediary on the |
14 | | petitioner's payment of the intermediary's
fees and expenses in |
15 | | advance of the commencement of the work of the
confidential |
16 | | intermediary. However, no fee shall be charged if the |
17 | | petitioner is an adult adopted or surrendered person and the |
18 | | sought-after relative is a birth parent who filed a Denial with |
19 | | the Registry prior to January 1, 2011, or filed a Birth Parent |
20 | | Preference Form on which Option E was selected after January 1, |
21 | | 2011 and more than 5 years have transpired since the birth |
22 | | parent filed the Denial of Information Exchange or Birth Parent |
23 | | Preference Form on which Option E was selected.
|
24 | | (e) Eligibility of intermediary. The court may appoint as |
25 | | confidential
intermediary any
person certified by the |
26 | | Department of Children and Family Services as qualified to |
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1 | | serve as a confidential
intermediary.
Certification shall be |
2 | | dependent upon the
confidential intermediary completing a |
3 | | course of training including, but not
limited to, applicable |
4 | | federal and State privacy laws.
|
5 | | (f) Confidential Intermediary Council. There shall be |
6 | | established under the
Department of Children and Family
|
7 | | Services a Confidential Intermediary Advisory Council. One |
8 | | member shall be an
attorney representing the Attorney General's |
9 | | Office appointed by the Attorney
General. One member shall be a |
10 | | currently certified confidential intermediary
appointed by the |
11 | | Director of the Department of Children and Family Services.
The |
12 | | Director shall also appoint 5 additional members. When making |
13 | | those
appointments, the Director shall consider advocates for |
14 | | adopted persons,
adoptive parents, birth parents, lawyers who |
15 | | represent clients in private
adoptions, lawyers specializing |
16 | | in privacy law, and representatives of agencies
involved in |
17 | | adoptions. The Director shall appoint one of the 7 members as
|
18 | | the chairperson. An attorney from the Department of Children |
19 | | and Family
Services
and the person directly responsible for |
20 | | administering the confidential
intermediary program shall |
21 | | serve as ex-officio, non-voting advisors to the
Council. |
22 | | Council members shall serve at the discretion of the Director |
23 | | and
shall receive no compensation other than reasonable |
24 | | expenses approved by the
Director. The Council shall meet no |
25 | | less than twice yearly and shall meet at least once yearly with |
26 | | the Registry Advisory Council, and shall make
recommendations |
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1 | | to the Director regarding the development of rules, procedures,
|
2 | | and forms that will ensure efficient and effective operation of |
3 | | the
confidential intermediary process, including:
|
4 | | (1) Standards for certification for confidential |
5 | | intermediaries.
|
6 | | (2) Oversight of methods used to verify that |
7 | | intermediaries are complying
with the appropriate laws.
|
8 | | (3) Training for confidential intermediaries, |
9 | | including training with
respect to federal and State |
10 | | privacy laws.
|
11 | | (4) The relationship between confidential |
12 | | intermediaries and the court
system, including the |
13 | | development of sample orders defining the scope of the
|
14 | | intermediaries' access to information.
|
15 | | (5) Any recent violations of policy or procedures by |
16 | | confidential
intermediaries and remedial steps, including |
17 | | decertification, to prevent future
violations.
|
18 | | (g) Access. Subject to the limitations of subsection (i) |
19 | | of this
Section, the
confidential
intermediary shall have |
20 | | access to vital records or a comparable public entity that |
21 | | maintains vital records in another state in accordance with |
22 | | that state's laws, maintained by the Department of
Public |
23 | | Health and its local designees for the maintenance of vital |
24 | | records or a comparable public entity that maintains vital |
25 | | records in another state in accordance with that state's laws |
26 | | and
all records of the court or any adoption agency,
public
or |
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1 | | private, as limited in this Section, which relate to the |
2 | | adoption or the identity and location of an
adopted or |
3 | | surrendered person, of an adult child or surviving spouse of a |
4 | | deceased adopted or surrendered person, or of a birth
parent, |
5 | | birth sibling, or the sibling of a deceased birth parent. The
|
6 | | confidential intermediary shall not have access to any personal |
7 | | health
information protected by the Standards for Privacy of |
8 | | Individually
Identifiable Health Information adopted by the |
9 | | U.S. Department of Health and
Human Services under the Health |
10 | | Insurance Portability and Accountability Act of
1996 unless the |
11 | | confidential intermediary has obtained written consent from |
12 | | the
person whose information is being sought by an adult |
13 | | adopted or surrendered person or, if that person is a minor |
14 | | child,
that person's parent or guardian. Confidential
|
15 | | intermediaries shall be authorized to inspect confidential |
16 | | relinquishment and
adoption records. The confidential |
17 | | intermediary shall not be authorized to
access medical
records, |
18 | | financial records, credit records, banking records, home |
19 | | studies,
attorney file records, or other personal records.
In |
20 | | cases where a birth parent is being sought, an adoption agency |
21 | | shall inform
the confidential intermediary of any statement |
22 | | filed pursuant to Section 18.3, hereinafter referred to as "the |
23 | | 18.3 statement",
indicating a desire of the surrendering birth |
24 | | parent to have identifying
information shared or to not have |
25 | | identifying information shared. If there was
a clear statement |
26 | | of intent by the sought-after birth parent not to have
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1 | | identifying information shared, the confidential intermediary |
2 | | shall discontinue
the search and inform the petitioning party |
3 | | of the sought-after relative's
intent unless the birth parent |
4 | | filed the 18.3 statement prior to the effective date of this |
5 | | amendatory Act of the 96th General Assembly and more than 5 |
6 | | years have elapsed since the filing of the 18.3 statement. If |
7 | | the adult adopted or surrendered person is the subject of an |
8 | | 18.3 statement indicating a desire not to establish contact |
9 | | which was filed more than 5 years prior to the search request, |
10 | | the confidential intermediary shall confirm the petitioner's |
11 | | desire to continue the search. Information
provided to the |
12 | | confidential intermediary by an adoption agency shall be
|
13 | | restricted to the full name, date of birth, place of birth, |
14 | | last known address,
last known telephone number of the |
15 | | sought-after relative or, if applicable,
of the children or |
16 | | siblings of the sought-after relative, and the 18.3 statement.
|
17 | | (h) Adoption agency disclosure of medical information. If |
18 | | the petitioner is
an adult adopted or surrendered person or the |
19 | | adoptive parent of a
minor and if the petitioner has signed a |
20 | | written authorization to disclose
personal medical |
21 | | information, an adoption agency disclosing information to a
|
22 | | confidential intermediary shall disclose available medical |
23 | | information about
the adopted or surrendered person from birth |
24 | | through adoption.
|
25 | | (i) Duties of confidential intermediary in conducting a |
26 | | search. In
conducting
a search under this Section, the |
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1 | | confidential intermediary shall first confirm
that there is no |
2 | | Denial of Information Exchange on file with the Illinois
|
3 | | Adoption Registry. If the petitioner is an adult child of an |
4 | | adopted or surrendered person
who is deceased, the
confidential |
5 | | intermediary shall additionally confirm that the adopted or |
6 | | surrendered person
did not file a Denial of Information |
7 | | Exchange or a Birth Parent Preference Form with Option E |
8 | | selected with the Illinois Adoption
Registry during his or her |
9 | | life. If there is a Denial on file with the Registry, the |
10 | | confidential intermediary must discontinue the search unless |
11 | | the petitioner is an adult adopted or surrendered person and |
12 | | the sought-after birth relative filed the Denial 5 years or |
13 | | more prior to the search or the birth parent has not been the |
14 | | object of a search through the State confidential intermediary |
15 | | program for 10 or more years. If the petitioner is an adult |
16 | | adopted or surrendered person and there is a Birth Parent |
17 | | Preference Form on file with the Registry and the birth parent |
18 | | who completed the form selected Option E, the confidential |
19 | | intermediary must discontinue the search unless 5 years or more |
20 | | have elapsed since the filing of the Birth Parent Preference |
21 | | Form. If the petitioner is an adult birth sibling of
an
adopted
|
22 | | or surrendered person or an adult sibling of a birth parent who |
23 | | is deceased,
the confidential intermediary shall
additionally |
24 | | confirm that the birth parent did not file a Denial of |
25 | | Information
Exchange or a Birth Parent Preference Form with |
26 | | Option E selected with the Registry during his or her life. If |
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1 | | the confidential
intermediary learns that a sought-after birth |
2 | | parent signed an 18.3 statement
indicating his or her intent |
3 | | not to have identifying information shared, and
did not later |
4 | | file an Information Exchange Authorization or a Birth Parent |
5 | | Preference Form with the
Registry, the confidential |
6 | | intermediary shall discontinue the search and inform
the |
7 | | petitioning party of the birth parent's intent, unless the |
8 | | petitioner is an adult adopted or surrendered person and 5 |
9 | | years or more have elapsed since the birth parent signed the |
10 | | statement indicating his or her intent not to have identifying |
11 | | information shared. In cases where the birth parent filed a |
12 | | Denial of Information Exchange or Birth Parent Preference Form |
13 | | where Option E was selected, or statement indicating his or her |
14 | | intent not to have identifying information shared less than 5 |
15 | | years prior to the search request and the petitioner is an |
16 | | adult adopted or surrendered person, the confidential |
17 | | intermediary shall inform the petitioner of the need to |
18 | | discontinue the search until 5 years have elapsed since the |
19 | | Denial of Information Exchange or Birth Parent Preference Form |
20 | | where Option E was selected, or statement
was filed; in cases |
21 | | where a birth parent was previously the subject of a search |
22 | | through the State confidential intermediary program, the |
23 | | confidential intermediary shall inform the petitioner of the |
24 | | need to discontinue the search until 10 years or more have |
25 | | elapsed since the initial search was closed. In cases where a |
26 | | birth parent has been the object of 2 searches through the |
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1 | | State confidential intermediary program, no subsequent search |
2 | | for the birth parent shall be authorized absent a court order |
3 | | to the contrary.
|
4 | | In conducting a search under this Section, the confidential |
5 | | intermediary
shall attempt to locate the relative or relatives |
6 | | from whom the petitioner has
requested information. If the |
7 | | sought-after relative is deceased
or cannot be located after a |
8 | | diligent search, the
confidential intermediary may contact |
9 | | other adult relatives of the
sought-after relative.
|
10 | | The confidential intermediary shall contact a sought-after |
11 | | relative on
behalf of the petitioner in a manner that respects |
12 | | the sought-after relative's
privacy and shall inform the |
13 | | sought-after relative of the petitioner's request
for medical |
14 | | information, identifying information or contact as stated in |
15 | | the
petition. Based upon the terms of the petitioner's request, |
16 | | the confidential
intermediary shall contact a sought-after |
17 | | relative on behalf of the petitioner
and inform the |
18 | | sought-after relative of the following options:
|
19 | | (1) The sought-after relative may totally reject one or |
20 | | all of the
requests for medical information, identifying |
21 | | information or
contact. The sought-after relative shall be |
22 | | informed that they can
provide a medical questionnaire to |
23 | | be forwarded to the petitioner
without releasing any |
24 | | identifying information. The confidential
intermediary |
25 | | shall inform the petitioner of the sought-after
relative's |
26 | | decision to reject the sharing of information or contact.
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1 | | (2) The sought-after relative may consent to |
2 | | completing a medical
questionnaire only. In this case, the |
3 | | confidential intermediary
shall provide the questionnaire |
4 | | and ask the sought-after relative to
complete it. The |
5 | | confidential intermediary shall forward the
completed |
6 | | questionnaire to the petitioner and inform the petitioner
|
7 | | of the sought-after relative's desire to not provide any |
8 | | additional
information.
|
9 | | (3) The sought-after relative may communicate with the |
10 | | petitioner
without having his or her identity disclosed. In |
11 | | this case, the
confidential intermediary shall arrange the |
12 | | desired communication
in a manner that protects the |
13 | | identity of the sought-after relative.
The confidential |
14 | | intermediary shall inform the petitioner of the
|
15 | | sought-after relative's decision to communicate but not |
16 | | disclose
his or her identity.
|
17 | | (4) The sought-after sought after relative may consent |
18 | | to initiate contact with the
petitioner. If both the |
19 | | petitioner and the sought-after relative or
relatives are |
20 | | eligible to register with the Illinois Adoption Registry,
|
21 | | the confidential intermediary shall provide the necessary
|
22 | | application forms and request that the sought-after |
23 | | relative
register with the Illinois Adoption Registry. If |
24 | | either the petitioner
or the sought-after relative or |
25 | | relatives are ineligible to register
with the Illinois |
26 | | Adoption Registry, the confidential intermediary
shall |
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1 | | obtain written consents from both parties that they wish to
|
2 | | disclose their identities to each other and to have contact |
3 | | with
each other.
|
4 | | (j) Oath. The confidential intermediary shall sign an oath |
5 | | of
confidentiality substantially as follows: "I, .........., |
6 | | being duly sworn, on
oath depose and say: As a condition of |
7 | | appointment as a confidential
intermediary, I affirm that:
|
8 | | (1) I will not disclose to the petitioner,
directly or |
9 | | indirectly, any confidential information
except in a |
10 | | manner consistent with the
law.
|
11 | | (2) I recognize that violation of this oath subjects me |
12 | | to civil liability
and to a potential finding of contempt |
13 | | of court.
................................
|
14 | | SUBSCRIBED AND SWORN to before me, a Notary Public, on (insert
|
15 | | date)
|
16 | | ................................."
|
17 | | (k) Sanctions.
|
18 | | (1) Any confidential intermediary who improperly |
19 | | discloses
confidential information identifying a |
20 | | sought-after relative shall be liable to
the sought-after |
21 | | relative for damages and may also be found in contempt of
|
22 | | court.
|
23 | | (2) Any person who learns a sought-after
relative's |
24 | | identity, directly or indirectly, through the use of |
25 | | procedures
provided in this Section and who improperly |
26 | | discloses information identifying
the sought-after |
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1 | | relative shall be liable to the sought-after relative for
|
2 | | actual damages plus minimum punitive damages of $10,000.
|
3 | | (3) The Department shall fine any confidential |
4 | | intermediary who improperly
discloses
confidential |
5 | | information in violation of item (1) or (2) of this |
6 | | subsection (k)
an amount up to $2,000 per improper |
7 | | disclosure. This fine does not affect
civil liability under |
8 | | item (2) of this subsection (k). The Department shall
|
9 | | deposit all fines and penalties collected under this |
10 | | Section into the Illinois
Adoption Registry and Medical |
11 | | Information Fund.
|
12 | | (l) Death of person being sought. Notwithstanding any other |
13 | | provision
of this Act, if the confidential intermediary |
14 | | discovers that the person
being sought has died, he or she |
15 | | shall report this fact to the court,
along with a copy of the |
16 | | death certificate. If the sought-after relative is a birth |
17 | | parent, the confidential intermediary shall also forward a copy |
18 | | of the birth parent's death certificate, if available, to the |
19 | | Registry for inclusion in the Registry file.
|
20 | | (m) Any confidential information obtained by the |
21 | | confidential intermediary
during the course of his or her |
22 | | search shall be kept strictly confidential
and shall be used |
23 | | for the purpose of arranging contact between the
petitioner and |
24 | | the sought-after birth relative. At the time the case is
|
25 | | closed, all identifying information shall be returned to the |
26 | | court for
inclusion in the impounded adoption file.
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1 | | (n) If the petitioner is an adopted or surrendered person |
2 | | 21 years of age or over or the
adoptive parent or legal |
3 | | guardian of an adopted or surrendered person under the age
of |
4 | | 21, any
non-identifying information, as defined in Section |
5 | | 18.4, that is
ascertained during the course of the search may |
6 | | be given in writing to
the petitioner at any time during the |
7 | | search before the case is closed.
|
8 | | (o) Except as provided in subsection (k) of this Section, |
9 | | no liability shall
accrue to
the State, any State agency, any |
10 | | judge, any officer or employee of the
court, any certified |
11 | | confidential intermediary, or any agency designated
to oversee |
12 | | confidential intermediary services for acts, omissions, or
|
13 | | efforts made in good faith within the scope of this Section.
|
14 | | (p) An adoption agency that has received a request from a |
15 | | confidential intermediary for the full name, date of birth, |
16 | | last known address, or last known telephone number of a |
17 | | sought-after relative pursuant to subsection (g) of Section |
18 | | 18.3a, or for medical information regarding a sought-after |
19 | | relative pursuant to subsection (h) of Section 18.3a, must |
20 | | satisfactorily comply with this court order within a period of |
21 | | 45 days. The court shall order the adoption agency to reimburse |
22 | | the petitioner in an amount equal to all payments made by the |
23 | | petitioner to the confidential intermediary, and the adoption |
24 | | agency shall be subject to a civil monetary penalty of $1,000 |
25 | | to be paid to the Department of Children and Family Services. |
26 | | Following the issuance of a court order finding that the |
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1 | | adoption agency has not complied with Section 18.3, the |
2 | | adoption agency shall be subject to a monetary penalty of $500 |
3 | | per day for each subsequent day of non-compliance. Proceeds |
4 | | from such fines shall be utilized by the Department of Children |
5 | | and Family Services to subsidize the fees of petitioners as |
6 | | referenced in subsection (d) of this Section. |
7 | | (q) Provide information to eligible petitioner. The |
8 | | confidential intermediary may provide to eligible petitioners |
9 | | as described in subsections (a) and (b) of this Section, the |
10 | | name of the child welfare agency which had legal custody of the |
11 | | surrendered person or responsibility for placing the |
12 | | surrendered person and any available contact information for |
13 | | such agency. In addition, the confidential intermediary may |
14 | | provide to such petitioners the name of the state in which the |
15 | | surrender occurred or in which the adoption was finalized. |
16 | | Any reimbursements and fines, notwithstanding any |
17 | | reimbursement directly to the petitioner, paid under this |
18 | | subsection are in addition to other remedies a court may |
19 | | otherwise impose by law. |
20 | | The Department of Children and Family Services shall submit |
21 | | reports to the Confidential Intermediary Advisory Council by |
22 | | July 1 and January 1 of each year in order to report the |
23 | | penalties assessed and collected under this subsection, the |
24 | | amounts of related deposits into the DCFS Children's Services |
25 | | Fund, and any expenditures from such deposits.
|
26 | | (Source: P.A. 96-661, eff. 8-25-09; 96-895, eff. 5-21-10.)
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1 | | (750 ILCS 50/18.6) (from Ch. 40, par. 1522.6)
|
2 | | Sec. 18.6. Registry fees. The Department of Public Health |
3 | | shall levy a
fee for each
registrant under Sections 18.05 |
4 | | through 18.5.
A $15 fee shall be charged for registering with |
5 | | the Illinois Adoption
Registry and Medical Information |
6 | | Exchange. However, this fee shall be
waived for all adopted or |
7 | | surrendered persons, surviving children and spouses of |
8 | | deceased adopted persons, adoptive parents,
legal guardians, |
9 | | birth parents, birth aunts, birth uncles, and
birth siblings |
10 | | who complete a Medical Information Exchange Questionnaire at |
11 | | the
time of registration and authorize its release to specified |
12 | | registered parties,
and for adoptive parents
registering |
13 | | within 12 months of the finalization of the
adoption. All |
14 | | persons who were registered with the Illinois Adoption Registry
|
15 | | prior to the effective date of this amendatory Act of 1999
and |
16 | | who wish to
update their registration may do so without charge.
|
17 | | No charge of any
kind shall be made for the withdrawal of any |
18 | | form provided in Section 18.2.
|
19 | | (Source: P.A. 96-895, eff. 5-21-10.)
|
20 | | Section 99. Effective date. This Act takes effect upon |
21 | | becoming law.".
|