97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB5062

 

Introduced 2/7/2012, by Rep. Keith P. Sommer

 

SYNOPSIS AS INTRODUCED:
 
750 ILCS 50/7  from Ch. 40, par. 1509
750 ILCS 50/10  from Ch. 40, par. 1512

    Amends the Adoption Act. Provides that service of process need not be directed to a minor defendant under 14 years of age for whom a guardian ad litem has been or will be appointed. Changes the form of consent to be given by a child 14 years of age or over or by an adult by adding a statement that the person enters his or her appearance in the proceeding and waives service of summons.


LRB097 18015 AJO 63238 b

 

 

A BILL FOR

 

HB5062LRB097 18015 AJO 63238 b

1    AN ACT concerning civil law.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Adoption Act is amended by changing Sections
57 and 10 as follows:
 
6    (750 ILCS 50/7)  (from Ch. 40, par. 1509)
7    Sec. 7. Process.
8    A. All persons named in the petition for adoption or
9standby adoption, other than the petitioners and any party who
10has previously either denied being a parent pursuant to Section
1112a of this Act or whose rights have been terminated pursuant
12to Section 12a of this Act, but including the person sought to
13be adopted, shall be made parties defendant by name, and if the
14name or names of any such persons are alleged in the petition
15to be unknown such persons shall be made parties defendant
16under the name and style of "All whom it may concern". In all
17such actions petitioner or his attorney shall file, at the
18office of the clerk of the court in which the action is
19pending, an affidavit showing that the defendant resides or has
20gone out of this State, or on due inquiry cannot be found, or
21is concealed within this State, so that process cannot be
22served upon him, and stating the place of residence of the
23defendant, if known, or that upon diligent inquiry his place of

 

 

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1residence cannot be ascertained, the clerk shall cause
2publication to be made in some newspaper published in the
3county in which the action is pending. If there is no newspaper
4published in that county, then the publication shall be in a
5newspaper published in an adjoining county in this State,
6having a circulation in the county in which such action is
7pending. In the event there is service on any of the parties by
8publication, the publication shall contain notice of pendency
9of the action, the name of the person to be adopted and the
10name of the parties to be served by publication, and the date
11on or after which default may be entered against such parties.
12Neither the name of petitioners nor the name of any party who
13has either surrendered said child, has given their consent to
14the adoption of the child, or whose parental rights have been
15terminated by a court of competent jurisdiction shall be
16included in the notice of publication. The Clerk shall also,
17within ten (10) days of the first publication of the notice,
18send a copy thereof by mail, addressed to each defendant whose
19place of residence is stated in such affidavit. The certificate
20of the Clerk that he sent the copies pursuant to this section
21is evidence that he has done so. Except as provided in this
22section pertaining to service by publication, all parties
23defendant shall be notified of the proceedings in the same
24manner as is now or may hereafter be required in other civil
25cases or proceedings, except that service of process need not
26be directed to a minor defendant under 14 years of age for whom

 

 

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1a guardian ad litem has been or will be appointed pursuant to
2paragraph (a) of subsection B of Section 13 of this Act. Any
3party defendant who is of age of 14 years or upward may waive
4service of process by entering an appearance in writing. The
5form to be used for publication shall be substantially as
6follows: "ADOPTION NOTICE - STATE OF ILLINOIS, County of ....,
7ss. - Circuit Court of .... County. In the matter of the
8Petition for the Adoption of ...., a ..male child. Adoption No.
9..... To-- .... (whom it may concern or the named parent) Take
10notice that a petition was filed in the Circuit Court of ....
11County, Illinois, for the adoption of a child named ..... Now,
12therefore, unless you ...., and all whom it may concern, file
13your answer to the Petition in the action or otherwise file
14your appearance therein, in the said Circuit Court of ....,
15County, Room ...., ...., in the City of ...., Illinois, on or
16before the .... day of ...., a default may be entered against
17you at any time after that day and a judgment entered in
18accordance with the prayer of said Petition. Dated, ....,
19Illinois, .... ...., Clerk. (Name and address of attorney for
20petitioners.)
21    B. A minor defendant who has been served in accordance with
22this Section may be defaulted in the same manner as any other
23defendant.
24    C. Notwithstanding any inconsistent provision of this or
25any other law, and in addition to the notice requirements of
26any law pertaining to persons other than those specified in

 

 

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1this subsection, the persons entitled to notice that a petition
2has been filed under Section 5 of this Act shall include:
3        (a) any person adjudicated by a court in this State to
4    be the father of the child;
5        (b) any person adjudicated by a court of another state
6    or territory of the United States to be the father of the
7    child, when a certified copy of the court order has been
8    filed with the Putative Father Registry under Section 12.1
9    of this Act;
10        (c) any person who at the time of the filing of the
11    petition is registered in the Putative Father Registry
12    under Section 12.1 of this Act as the putative father of
13    the child;
14        (d) any person who is recorded on the child's birth
15    certificate as the child's father;
16        (e) any person who is openly living with the child or
17    the child's mother at the time the proceeding is initiated
18    and who is holding himself out to be the child's father;
19        (f) any person who has been identified as the child's
20    father by the mother in a written, sworn statement,
21    including an Affidavit of Identification as specified
22    under Section 11 of this Act;
23        (g) any person who was married to the child's mother on
24    the date of the child's birth or within 300 days prior to
25    the child's birth.
26    The sole purpose of notice under this Section shall be to

 

 

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1enable the person receiving notice to appear in the adoption
2proceedings to present evidence to the court relevant to
3whether the consent or surrender of the person to the adoption
4is required pursuant to Section 8 of this Act. If the court
5determines that the consent or surrender of the person is not
6required pursuant to Section 8, then the person shall not be
7entitled to participate in the proceedings or to any further
8notice of the proceedings.
9(Source: P.A. 94-530, eff. 1-1-06.)
 
10    (750 ILCS 50/10)  (from Ch. 40, par. 1512)
11    Sec. 10. Forms of consent and surrender; execution and
12acknowledgment thereof.
13    A. The form of consent required for the adoption of a born
14child shall be substantially as follows:
15
FINAL AND IRREVOCABLE CONSENT TO ADOPTION
16    I, ...., (relationship, e.g., mother, father, relative,
17guardian) of ...., a ..male child, state:
18    That such child was born on .... at ....
19    That I reside at ...., County of .... and State of ....
20    That I am of the age of .... years.
21    That I hereby enter my appearance in this proceeding and
22waive service of summons on me.
23    That I hereby acknowledge that I have been provided with a
24copy of the Birth Parent Rights and Responsibilities-Private
25Form before signing this Consent and that I have had time to

 

 

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1read, or have had read to me, this Form. I understand that if I
2do not receive any of the rights as described in this Form, it
3shall not constitute a basis to revoke this Final and
4Irrevocable Consent.
5    That I do hereby consent and agree to the adoption of such
6child.
7    That I wish to and understand that by signing this consent
8I do irrevocably and permanently give up all custody and other
9parental rights I have to such child.
10    That I understand such child will be placed for adoption
11and that I cannot under any circumstances, after signing this
12document, change my mind and revoke or cancel this consent or
13obtain or recover custody or any other rights over such child.
14That I have read and understand the above and I am signing it
15as my free and voluntary act.
16    Dated (insert date).
17.........................
 
18    If under Section 8 the consent of more than one person is
19required, then each such person shall execute a separate
20consent.
21    A-1. (1) The form of the Final and Irrevocable Consent to
22Adoption by a Specified Person or Persons: Non-DCFS Case set
23forth in this subsection A-1 is to be used by legal parents
24only. This form is not to be used in cases in which there is a
25pending petition under Section 2-13 of the Juvenile Court Act

 

 

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1of 1987.
2    (2) The form of the Final and Irrevocable Consent to
3Adoption by a Specified Person or Persons in a non-DCFS case
4shall have the caption of the proceeding in which it is to be
5filed and shall be substantially as follows:
6
FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY
7
A SPECIFIED PERSON OR PERSONS; NON-DCFS CASE
8    I, ...., (relationship, e.g., mother, father) of ...., a
9..male child, state:
10    1. That such child was born on ...., at ....., City of ...
11and State of ....
12    2. That I reside at ...., County of .... and State of ....
13    3. That I am of the age of .... years.
14    4. That I hereby enter my appearance in this proceeding and
15waive service of summons on me.
16    5. That I hereby acknowledge that I have been provided a
17copy of the Birth Parent Rights and Responsibilities-Private
18Form before signing this Consent and that I have had time to
19read, or have had read to me, this Form and that I understand
20the Rights and Responsibilities described in this Form. I
21understand that if I do not receive any of my rights as
22described in said Form, it shall not constitute a basis to
23revoke this Final and Irrevocable Consent to Adoption by a
24Specified Person.
25    6. That I do hereby consent and agree to the adoption of
26such child by .... (specified persons) only.

 

 

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1    7. That I wish to and understand that upon signing this
2consent I do irrevocably and permanently give up all custody
3and other parental rights I have to such child if such child is
4adopted by .... (specified person or persons). I hereby
5transfer all of my rights to the custody, care and control of
6such child to ............................. (specified person
7or persons).
8    8. That I understand such child will be adopted by
9....................... (specified person or persons) and that
10I cannot under any circumstances, after signing this document,
11change my mind and revoke or cancel this consent or obtain or
12recover custody or any other rights over such child if
13............................ (specified person or persons)
14adopt(s) such child; PROVIDED that each specified person has
15filed or shall file, within 60 days from the date hereof, a
16petition for the adoption of such child.
17    9. That if the specified person or persons designated
18herein do not file a petition for adoption within the
19time-frame specified above, or, if said petition for adoption
20is filed within the time-frame specified above but the adoption
21petition is dismissed with prejudice or the adoption proceeding
22is otherwise concluded without an order declaring the child to
23be the adopted child of the specified person or persons, then I
24understand that I will receive written notice of such
25circumstances within 10 business days of their occurrence. I
26understand that the notice will be directed to me using the

 

 

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1contact information I have provided in this consent. I
2understand that I will have 10 business days from the date that
3the written notice is sent to me to respond, within which time
4I may request the Court to declare this consent voidable and
5return the child to me. I further understand that the Court
6will make the final decision of whether or not the child will
7be returned to me. If I do not make such request within 10
8business days of the date of the notice, then I expressly waive
9any other notice or service of process in any legal proceeding
10for the adoption of the child.
11    10. That I expressly acknowledge that nothing in this
12Consent impairs the validity and absolute finality of this
13Consent under any circumstance other than those described in
14paragraph 9 of this Consent.
15    11. That I understand that I have a remaining duty and
16obligation to keep .............. (insert name and address of
17the attorney for the specified person or persons) informed of
18my current address or other preferred contact information until
19this adoption has been finalized. My failure to do so may
20result in the termination of my parental rights and the child
21being placed for adoption in another home.
22    12. That I do expressly waive any other notice or service
23of process in any of the legal proceedings for the adoption of
24the child as long as the adoption proceeding by the specified
25person or persons is pending.
26    13. That I have read and understand the above and I am

 

 

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1signing it as my free and voluntary act.
2    14. That I acknowledge that this consent is valid even if
3the specified person or persons separate or divorce or one of
4the specified persons dies prior to the entry of the final
5judgment for adoption.
6    Dated (insert date).
7    .............................................
8    Signature of parent.
9    .............................................
10    Address of parent.
11    .............................................
12    Phone number(s) of parent.
13    .............................................
14    Personal email(s) of parent.
15    .............................................
16    (3) The form of the certificate of acknowledgement for a
17Final and Irrevocable Consent for Adoption by a Specified
18Person or Persons: Non-DCFS Case shall be substantially as
19follows:
 
20STATE OF ..............)
21                       ) SS.
22COUNTY OF .............)
23    I, .................... (Name of Judge or other person),
24..................... (official title, name, and address),
25certify that ............., personally known to me to be the

 

 

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1same person whose name is subscribed to the foregoing Final and
2Irrevocable Consent for Adoption by a Specified Person or
3Persons; non-DCFS case, appeared before me this day in person
4and acknowledged that (she)(he) signed and delivered the
5consent as (her)(his) free and voluntary act, for the specified
6purpose. I am further satisfied that, before signing this
7Consent, ........ has read, or has had read to him or her, the
8Birth Parent Rights and Responsibilities-Private Form.
9    A-2. Birth Parent Rights and Responsibilities-Private
10Form. The Birth Parent Rights and Responsibilities-Private
11Form must be read by, or have been read to, any person
12executing a Final and Irrevocable Consent to Adoption under
13subsection A, a Final and Irrevocable Consent to Adoption by a
14Specified Person or Persons: Non-DCFS Case under subsection
15A-1, or a Consent to Adoption of Unborn Child under subsection
16B prior to the execution of said Consent. The form of the Birth
17Parent Rights and Responsibilities-Private Form shall be
18substantially as follows:
19
Birth Parent Rights and Responsibilities-Private Form
20    As a birth parent in the State of Illinois, you have the
21right:
22    1. To have your own attorney represent you. The prospective
23adoptive parents may agree to pay for the cost of your attorney
24in a manner consistent with Illinois law, but they are not
25required to do so.
26    2. To be treated with dignity and respect at all times and

 

 

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1to make decisions free from coercion and pressure.
2    3. To receive counseling before and after signing a Final
3and Irrevocable Consent to Adoption ("Consent"), a Final and
4Irrevocable Consent to Adoption by a Specified Person or
5Persons: Non-DCFS Case ("Specified Consent"), or a Consent to
6Adoption of Unborn Child ("Unborn Consent"). The prospective
7adoptive parents may agree to pay for the cost of counseling in
8a manner consistent with Illinois law, but they are not
9required to do so.
10    4. To ask to be involved in choosing your child's
11prospective adoptive parents and to ask to meet them.
12    5. To ask your child's prospective adoptive parents any
13questions that pertain to your decision to place your child
14with them.
15    6. To see your child before signing a Consent or Specified
16Consent.
17    7. To request contact with your child and/or the child's
18prospective adoptive parents, with the understanding that any
19promises regarding contact with your child or receipt of
20information about the child after signing a Consent, Specified
21Consent, or Unborn Consent cannot be enforced under Illinois
22law.
23    8. To receive copies of all documents that you sign and
24have those documents provided to you in your preferred
25language.
26    9. To request that your identifying information remain

 

 

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1confidential, unless required otherwise by Illinois law or
2court order, and to register with the Illinois Adoption
3Registry and Medical Information Exchange.
4    10. To work with an adoption agency or attorney of your
5choice, or change said agency or attorney, provided you
6promptly inform all of the parties currently involved.
7    11. To receive, upon request, a written list of any
8promised support, financial or otherwise, from your attorney or
9the attorney for your child's prospective adoptive parents.
10    12. To delay signing a Consent, Specified Consent, or
11Unborn Consent if you are not ready to do so.
12    13. To decline to sign a Consent, Specified Consent, or
13Unborn Consent even if you have received financial support from
14the prospective adoptive parents.
15    If you do not receive any of the rights described in this
16Form, it shall not be a basis to revoke a Consent, Specified
17Consent, or Unborn Consent.
18    As a Birth Parent in the State of Illinois, you have the
19responsibility:
20    1. To carefully consider your reasons for choosing
21adoption.
22    2. To voluntarily provide all known medical, background,
23and family information about yourself and your immediate family
24to your child's prospective adoptive parents or their attorney.
25For the health of your child, you are strongly encouraged, but
26not required, to provide all known medical, background, and

 

 

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1family history information about yourself and your family to
2your child's prospective adoptive parents or their attorney.
3    3. (Birth mothers only) To accurately complete an Affidavit
4of Identification, which identifies the father of the child
5when known, with the understanding that a birth mother has a
6right to decline to identify the birth father.
7    4. To not accept financial support or reimbursement of
8pregnancy related expenses simultaneously from more than one
9source.
10    B. The form of consent required for the adoption of an
11unborn child shall be substantially as follows:
12
CONSENT TO ADOPTION OF UNBORN CHILD
13    I, ...., state:
14    That I am the father of a child expected to be born on or
15about .... to .... (name of mother).
16    That I reside at .... County of ...., and State of .....
17    That I am of the age of .... years.
18    That I hereby enter my appearance in such adoption
19proceeding and waive service of summons on me.
20    That I hereby acknowledge that I have been provided with a
21copy of the Birth Parent Rights and Responsibilities-Private
22Form before signing this Consent, and that I have had time to
23read, or have had read to me, this Form. I understand that if I
24do not receive any of the rights as described in this Form, it
25shall not constitute a basis to revoke this Consent to Adoption
26of Unborn Child.

 

 

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1    That I do hereby consent and agree to the adoption of such
2child, and that I have not previously executed a consent or
3surrender with respect to such child.
4    That I wish to and do understand that by signing this
5consent I do irrevocably and permanently give up all custody
6and other parental rights I have to such child, except that I
7have the right to revoke this consent by giving written notice
8of my revocation not later than 72 hours after the birth of the
9child.
10    That I understand such child will be placed for adoption
11and that, except as hereinabove provided, I cannot under any
12circumstances, after signing this document, change my mind and
13revoke or cancel this consent or obtain or recover custody or
14any other rights over such child.
15    That I have read and understand the above and I am signing
16it as my free and voluntary act.
17    Dated (insert date).
18........................
19    B-5. (1) The parent of a child may execute a consent to
20standby adoption by a specified person or persons. A consent
21under this subsection B-5 shall be acknowledged by a parent
22pursuant to subsection H and subsection K of this Section. The
23form of consent required for the standby adoption of a born
24child effective at a future date when the consenting parent of
25the child dies or requests that a final judgment of adoption be
26entered shall be substantially as follows:

 

 

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1
FINAL AND IRREVOCABLE CONSENT
2
TO STANDBY ADOPTION
3    I, ..., (relationship, e.g. mother or father) of ...., a
4..male child, state:
5    That the child was born on .... at .....
6    That I reside at ...., County of ...., and State of .....
7    That I am of the age of .... years.
8    That I hereby enter my appearance in this proceeding and
9waive service of summons on me in this action only.
10    That I do hereby consent and agree to the standby adoption
11of the child, and that I have not previously executed a consent
12or surrender with respect to the child.
13    That I wish to and understand that by signing this consent
14I do irrevocably and permanently give up all custody and other
15parental rights I have to the child, effective upon (my death)
16(the child's other parent's death) or upon (my) (the other
17parent's) request for the entry of a final judgment for
18adoption if ..... (specified person or persons) adopt my child.
19    That I understand that until (I die) (the child's other
20parent dies), I retain all legal rights and obligations
21concerning the child, but at that time, I irrevocably give all
22custody and other parental rights to .... (specified person or
23persons).
24    I understand my child will be adopted by ....... (specified
25person or persons) only and that I cannot, under any
26circumstances, after signing this document, change my mind and

 

 

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1revoke or cancel this consent or obtain or recover custody or
2any other rights over my child if ..... (specified person or
3persons) adopt my child.
4    I understand that this consent to standby adoption is valid
5only if the petition for standby adoption is filed and that if
6....... (specified person or persons), for any reason, cannot
7or will not file a petition for standby adoption or if his,
8her, or their petition for standby adoption is denied, then
9this consent is void. I have the right to notice of any other
10proceeding that could affect my parental rights.
11    That I have read and understand the above and I am signing
12it as my free and voluntary act.
13    Dated (insert date).
14....................
 
15    If under Section 8 the consent of more than one person is
16required, then each such person shall execute a separate
17consent. A separate consent shall be executed for each child.
18    (2) If the parent consents to a standby adoption by 2
19specified persons, then the form shall contain 2 additional
20paragraphs in substantially the following form:
21    If .... (specified persons) obtain a judgment of
22dissolution of marriage before the judgment for adoption is
23entered, then ..... (specified person) shall adopt my child. I
24understand that I cannot change my mind and revoke this consent
25or obtain or recover custody of my child if ..... (specified

 

 

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1persons) obtain a judgment of dissolution of marriage and .....
2(specified person) adopts my child. I understand that I cannot
3change my mind and revoke this consent if ...... (specified
4persons) obtain a judgment of dissolution of marriage before
5the adoption is final. I understand that this consent to
6adoption has no effect on who will get custody of my child if
7..... (specified persons) obtain a judgment of dissolution of
8marriage after the adoption is final. I understand that if
9either ..... (specified persons) dies before the petition to
10adopt my child is granted, then the surviving person may adopt
11my child. I understand that I cannot change my mind and revoke
12this consent or obtain or recover custody of my child if the
13surviving person adopts my child.
14    A consent to standby adoption by specified persons on this
15form shall have no effect on a court's determination of custody
16or visitation under the Illinois Marriage and Dissolution of
17Marriage Act if the marriage of the specified persons is
18dissolved before the adoption is final.
19    (3) The form of the certificate of acknowledgement for a
20Final and Irrevocable Consent for Standby Adoption shall be
21substantially as follows:
 
22STATE OF .....)
23              ) SS.
24COUNTY OF ....)
 

 

 

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1    I, ....... (name of Judge or other person) ..... (official
2title, name, and address), certify that ......., personally
3known to me to be the same person whose name is subscribed to
4the foregoing Final and Irrevocable Consent to Standby
5Adoption, appeared before me this day in person and
6acknowledged that (she) (he) signed and delivered the consent
7as (her) (his) free and voluntary act, for the specified
8purpose.
9    I have fully explained that this consent to adoption is
10valid only if the petition to adopt is filed, and that if the
11specified person or persons, for any reason, cannot or will not
12adopt the child or if the adoption petition is denied, then
13this consent will be void. I have fully explained that if the
14specified person or persons adopt the child, by signing this
15consent (she) (he) is irrevocably and permanently
16relinquishing all parental rights to the child, and (she) (he)
17has stated that such is (her) (his) intention and desire.
18    Dated (insert date).
19    Signature ..............................
20    (4) If a consent to standby adoption is executed in this
21form, the consent shall be valid only if the specified person
22or persons adopt the child. The consent shall be void if:
23    (a) the specified person or persons do not file a petition
24for standby adoption of the child; or
25    (b) a court denies the standby adoption petition.
26    The parent shall not need to take further action to revoke

 

 

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1the consent if the standby adoption by the specified person or
2persons does not occur, notwithstanding the provisions of
3Section 11 of this Act.
4    C. The form of surrender to any agency given by a parent of
5a born child who is to be subsequently placed for adoption
6shall be substantially as follows and shall contain such other
7facts and statements as the particular agency shall require.
8
FINAL AND IRREVOCABLE SURRENDER
9
FOR PURPOSES OF ADOPTION
10    I, .... (relationship, e.g., mother, father, relative,
11guardian) of ...., a ..male child, state:
12    That such child was born on ...., at .....
13    That I reside at ...., County of ...., and State of .....
14    That I am of the age of .... years.
15    That I do hereby surrender and entrust the entire custody
16and control of such child to the .... (the "Agency"), a
17(public) (licensed) child welfare agency with its principal
18office in the City of ...., County of .... and State of ....,
19for the purpose of enabling it to care for and supervise the
20care of such child, to place such child for adoption and to
21consent to the legal adoption of such child.
22    That I hereby grant to the Agency full power and authority
23to place such child with any person or persons it may in its
24sole discretion select to become the adopting parent or parents
25and to consent to the legal adoption of such child by such
26person or persons; and to take any and all measures which, in

 

 

HB5062- 21 -LRB097 18015 AJO 63238 b

1the judgment of the Agency, may be for the best interests of
2such child, including authorizing medical, surgical and dental
3care and treatment including inoculation and anaesthesia for
4such child.
5    That I wish to and understand that by signing this
6surrender I do irrevocably and permanently give up all custody
7and other parental rights I have to such child.
8    That I understand I cannot under any circumstances, after
9signing this surrender, change my mind and revoke or cancel
10this surrender or obtain or recover custody or any other rights
11over such child.
12    That I have read and understand the above and I am signing
13it as my free and voluntary act.
14    Dated (insert date).
15........................
16    C-5. The form of a Final and Irrevocable Designated
17Surrender for Purposes of Adoption to any agency given by a
18parent of a born child who is to be subsequently placed for
19adoption is to be used by legal parents only. The form shall be
20substantially as follows and shall contain such other facts and
21statements as the particular agency shall require:
22
FINAL AND IRREVOCABLE DESIGNATED SURRENDER
23
FOR PURPOSES OF ADOPTION
24    I, .... (relationship, e.g., mother, father, relative,
25guardian) of ...., a ..male child, state:
26    1. That such child was born on ...., at .....

 

 

HB5062- 22 -LRB097 18015 AJO 63238 b

1    2. That I reside at ...., County of ...., and State of
2.....
3    3. That I am of the age of .... years.
4    4. That I do hereby surrender and entrust the entire
5custody and control of such child to the .... (the "Agency"), a
6(public) (licensed) child welfare agency with its principal
7office in the City of ...., County of .... and State of ....,
8for the purpose of enabling it to care for and supervise the
9care of such child, to place such child for adoption with
10............................. (specified person or persons)
11and to consent to the legal adoption of such child and to take
12any and all measures which, in the judgment of the Agency, may
13be for the best interests of such child, including authorizing
14medical, surgical and dental care and treatment including
15inoculation and anesthesia for such child.
16    5. That I wish to and understand that by signing this
17surrender I do irrevocably and permanently give up all custody
18and other parental rights I have to such child.
19    6. That if the petition for adoption is not filed by the
20specified person or persons designated herein or, if the
21petition for adoption is filed but the adoption petition is
22dismissed with prejudice or the adoption proceeding is
23otherwise concluded without an order declaring the child to be
24the adopted child of each specified person, then I understand
25that the Agency will provide notice to me within 10 business
26days and that such notice will be directed to me using the

 

 

HB5062- 23 -LRB097 18015 AJO 63238 b

1contact information I have provided to the Agency. I understand
2that I will have 10 business days from the date that the Agency
3sends me its notice to respond, within which time I may choose
4to designate other adoptive parent(s). However, I acknowledge
5that the Agency has full power and authority to place the child
6for adoption with any person or persons it may in its sole
7discretion select to become the adopting parent or parents and
8to consent to the legal adoption of the child by such person or
9persons.
10    7. That I acknowledge that this surrender is valid even if
11the specified persons separate or divorce or one of the
12specified persons dies prior to the entry of the final judgment
13for adoption.
14    8. That I expressly acknowledge that the above paragraphs 6
15and 7 do not impair the validity and absolute finality of this
16surrender under any circumstance.
17    9. That I understand that I have a remaining obligation to
18keep the Agency informed of my current contact information
19until the adoption of the child has been finalized if I wish to
20be notified in the event the adoption by the specified
21person(s) cannot proceed.
22    10. That I understand I cannot under any circumstances,
23after signing this surrender, change my mind and revoke or
24cancel this surrender or obtain or recover custody or any other
25rights over such child.
26    11. That I have read and understand the above and I am

 

 

HB5062- 24 -LRB097 18015 AJO 63238 b

1signing it as my free and voluntary act.
2    Dated (insert date).
3..............................
4    D. The form of surrender to an agency given by a parent of
5an unborn child who is to be subsequently placed for adoption
6shall be substantially as follows and shall contain such other
7facts and statements as the particular agency shall require.
8
SURRENDER OF UNBORN CHILD FOR
9
PURPOSES OF ADOPTION
10    I, .... (father), state:
11    That I am the father of a child expected to be born on or
12about .... to .... (name of mother).
13    That I reside at ...., County of ...., and State of .....
14    That I am of the age of .... years.
15    That I do hereby surrender and entrust the entire custody
16and control of such child to the .... (the "Agency"), a
17(public) (licensed) child welfare agency with its principal
18office in the City of ...., County of .... and State of ....,
19for the purpose of enabling it to care for and supervise the
20care of such child, to place such child for adoption and to
21consent to the legal adoption of such child, and that I have
22not previously executed a consent or surrender with respect to
23such child.
24    That I hereby grant to the Agency full power and authority
25to place such child with any person or persons it may in its
26sole discretion select to become the adopting parent or parents

 

 

HB5062- 25 -LRB097 18015 AJO 63238 b

1and to consent to the legal adoption of such child by such
2person or persons; and to take any and all measures which, in
3the judgment of the Agency, may be for the best interests of
4such child, including authorizing medical, surgical and dental
5care and treatment, including inoculation and anaesthesia for
6such child.
7    That I wish to and understand that by signing this
8surrender I do irrevocably and permanently give up all custody
9and other parental rights I have to such child.
10    That I understand I cannot under any circumstances, after
11signing this surrender, change my mind and revoke or cancel
12this surrender or obtain or recover custody or any other rights
13over such child, except that I have the right to revoke this
14surrender by giving written notice of my revocation not later
15than 72 hours after the birth of such child.
16    That I have read and understand the above and I am signing
17it as my free and voluntary act.
18    Dated (insert date).
19........................
20    E. The form of consent required from the parents for the
21adoption of an adult, when such adult elects to obtain such
22consent, shall be substantially as follows:
23
CONSENT
24    I, ...., (father) (mother) of ...., an adult, state:
25    That I reside at ...., County of .... and State of .....
26    That I do hereby consent and agree to the adoption of such

 

 

HB5062- 26 -LRB097 18015 AJO 63238 b

1adult by .... and .....
2    Dated (insert date).
3.........................
4    F. The form of consent required for the adoption of a child
5of the age of 14 years or over upwards, or of an adult, to be
6given by such person, shall be substantially as follows:
7
CONSENT
8    I, ...., state:
9    That I reside at ...., County of .... and State of .....
10That I am of the age of .... years. That I hereby enter my
11appearance in this proceeding and waive service of summons on
12me. That I consent and agree to my adoption by .... and .....
13    Dated (insert date).
14........................
15    G. The form of consent given by an agency to the adoption
16by specified persons of a child previously surrendered to it
17shall set forth that the agency has the authority to execute
18such consent. The form of consent given by a guardian of the
19person of a child sought to be adopted, appointed by a court of
20competent jurisdiction, shall set forth the facts of such
21appointment and the authority of the guardian to execute such
22consent.
23    H. A consent (other than that given by an agency, or
24guardian of the person of the child sought to be adopted who
25was appointed by a court of competent jurisdiction) shall be
26acknowledged by a parent before a judge of a court of competent

 

 

HB5062- 27 -LRB097 18015 AJO 63238 b

1jurisdiction or, except as otherwise provided in this Act,
2before a representative of an agency, or before a person, other
3than the attorney for the prospective adoptive parent or
4parents, designated by a court of competent jurisdiction.
5    I. A surrender, or any other document equivalent to a
6surrender, by which a child is surrendered to an agency shall
7be acknowledged by the person signing such surrender, or other
8document, before a judge of a court of competent jurisdiction,
9or, except as otherwise provided in this Act, before a
10representative of an agency, or before a person designated by a
11court of competent jurisdiction.
12    J. The form of the certificate of acknowledgment for a
13consent, a surrender, or any other document equivalent to a
14surrender, shall be substantially as follows:
15STATE OF ....)
16             ) SS.
17COUNTY OF ...)
18    I, .... (Name of judge or other person), .... (official
19title, name and location of court or status or position of
20other person), certify that ...., personally known to me to be
21the same person whose name is subscribed to the foregoing
22(consent) (surrender), appeared before me this day in person
23and acknowledged that (she) (he) signed and delivered such
24(consent) (surrender) as (her) (his) free and voluntary act,
25for the specified purpose.
26    I have fully explained that by signing such (consent)

 

 

HB5062- 28 -LRB097 18015 AJO 63238 b

1(surrender) (she) (he) is irrevocably relinquishing all
2parental rights to such child or adult and (she) (he) has
3stated that such is (her) (his) intention and desire. (Add if
4Consent only) I am further satisfied that, before signing this
5Consent, ........ has read, or has had read to him or her, the
6Birth Parent Rights and Responsibilities-Private Form.
7    Dated (insert date).
8    Signature ...............
9    K. When the execution of a consent or a surrender is
10acknowledged before someone other than a judge, such other
11person shall have his or her signature on the certificate
12acknowledged before a notary public, in form substantially as
13follows:
14STATE OF ....)
15             ) SS.
16COUNTY OF ...)
17    I, a Notary Public, in and for the County of ......, in the
18State of ......, certify that ...., personally known to me to
19be the same person whose name is subscribed to the foregoing
20certificate of acknowledgment, appeared before me in person and
21acknowledged that (she) (he) signed such certificate as (her)
22(his) free and voluntary act and that the statements made in
23the certificate are true.
24    Dated (insert date).
25    
Signature ...................... Notary Public
26
(official seal)

 

 

 

HB5062- 29 -LRB097 18015 AJO 63238 b

1    There shall be attached a certificate of magistracy, or
2other comparable proof of office of the notary public
3satisfactory to the court, to a consent signed and acknowledged
4in another state.
5    L. A surrender or consent executed and acknowledged outside
6of this State, either in accordance with the law of this State
7or in accordance with the law of the place where executed, is
8valid.
9    M. Where a consent or a surrender is signed in a foreign
10country, the execution of such consent shall be acknowledged or
11affirmed in a manner conformable to the law and procedure of
12such country.
13    N. If the person signing a consent or surrender is in the
14military service of the United States, the execution of such
15consent or surrender may be acknowledged before a commissioned
16officer and the signature of such officer on such certificate
17shall be verified or acknowledged before a notary public or by
18such other procedure as is then in effect for such division or
19branch of the armed forces.
20    O. (1) The parent or parents of a child in whose interests
21a petition under Section 2-13 of the Juvenile Court Act of 1987
22is pending may, with the approval of the designated
23representative of the Department of Children and Family
24Services, execute a consent to adoption by a specified person
25or persons:

 

 

HB5062- 30 -LRB097 18015 AJO 63238 b

1        (a) in whose physical custody the child has resided for
2    at least 6 months; or
3        (b) in whose physical custody at least one sibling of
4    the child who is the subject of this consent has resided
5    for at least 6 months, and the child who is the subject of
6    this consent is currently residing in this foster home; or
7        (c) in whose physical custody a child under one year of
8    age has resided for at least 3 months.
9A consent under this subsection O shall be acknowledged by a
10parent pursuant to subsection H and subsection K of this
11Section.
12    (2) The consent to adoption by a specified person or
13persons shall have the caption of the proceeding in which it is
14to be filed and shall be substantially as follows:
15
FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY
16
A SPECIFIED PERSON OR PERSONS: DCFS CASE
17    I, ......................................, the
18.................. (mother or father) of a ....male child,
19state:
20         My child ............................ (name of child)
21    was born on (insert date) at .................... Hospital
22    in ................ County, State of ...............
23         I reside at ......................, County of
24    ............. and State of ..............
25         I, ..........................., am .... years old.
26         I enter my appearance in this action to adopt my child

 

 

HB5062- 31 -LRB097 18015 AJO 63238 b

1    by the person or persons specified herein by me and waive
2    service of summons on me in this action only.
3         I consent to the adoption of my child by
4    ............................. (specified person or
5    persons) only.
6         I wish to sign this consent and I understand that by
7    signing this consent I irrevocably and permanently give up
8    all parental rights I have to my child if my child is
9    adopted by ............................. (specified person
10    or persons).
11         I understand my child will be adopted by
12    ............................. (specified person or
13    persons) only and that I cannot under any circumstances,
14    after signing this document, change my mind and revoke or
15    cancel this consent or obtain or recover custody or any
16    other rights over my child if ............................
17    (specified person or persons) adopt my child.
18         I understand that this consent to adoption is valid
19    only if the petition to adopt is filed within one year from
20    the date that I sign it and that if .......................
21    (specified person or persons), for any reason, cannot or
22    will not file a petition to adopt my child within that one
23    year period or if their adoption petition is denied, then
24    this consent will be voidable after one year upon the
25    timely filing of my motion. If I file this motion before
26    the filing of the petition for adoption, I understand that

 

 

HB5062- 32 -LRB097 18015 AJO 63238 b

1    the court shall revoke this specific consent. I have the
2    right to notice of any other proceeding that could affect
3    my parental rights, except for the proceeding for
4    ............. (specified person or persons) to adopt my
5    child.
6         I have read and understand the above and I am signing
7    it as my free and voluntary act.
8        Dated (insert date).
9        .............................................
10        Signature of parent
11    (3) If the parent consents to an adoption by 2 specified
12persons, then the form shall contain 2 additional paragraphs in
13substantially the following form:
14         If ............... (specified persons) get a divorce
15    before the petition to adopt my child is granted, then
16    .......... (specified person) shall adopt my child. I
17    understand that I cannot change my mind and revoke this
18    consent or obtain or recover custody over my child if
19    ............. (specified persons) divorce and
20    ............. (specified person) adopts my child. I
21    understand that I cannot change my mind and revoke this
22    consent or obtain or recover custody over my child if
23    ................. (specified persons) divorce after the
24    adoption is final. I understand that this consent to
25    adoption has no effect on who will get custody of my child
26    if they divorce after the adoption is final.

 

 

HB5062- 33 -LRB097 18015 AJO 63238 b

1         I understand that if either ...............
2    (specified persons) dies before the petition to adopt my
3    child is granted, then the surviving person can adopt my
4    child. I understand that I cannot change my mind and revoke
5    this consent or obtain or recover custody over my child if
6    the surviving person adopts my child.
7    A consent to adoption by specified persons on this form
8shall have no effect on a court's determination of custody or
9visitation under the Illinois Marriage and Dissolution of
10Marriage Act if the marriage of the specified persons is
11dissolved after the adoption is final.
12    (4) The form of the certificate of acknowledgement for a
13Final and Irrevocable Consent for Adoption by a Specified
14Person or Persons: DCFS Case shall be substantially as follows:
 
15STATE OF ..............)
16                       ) SS.
17COUNTY OF .............)
 
18    I, .................... (Name of Judge or other person),
19..................... (official title, name, and address),
20certify that ............., personally known to me to be the
21same person whose name is subscribed to the foregoing Final and
22Irrevocable Consent for Adoption by a Specified Person or
23Persons, appeared before me this day in person and acknowledged
24that (she)(he) signed and delivered the consent as (her)(his)

 

 

HB5062- 34 -LRB097 18015 AJO 63238 b

1free and voluntary act, for the specified purpose.
2    I have fully explained that this consent to adoption is
3valid only if the petition to adopt is filed within one year
4from the date that it is signed, and that if the specified
5person or persons, for any reason, cannot or will not adopt the
6child or if the adoption petition is denied, then this consent
7will be voidable after one year upon the timely filing of a
8motion by the parent to revoke the consent. I explained that if
9this motion is filed before the filing of the petition for
10adoption, the court shall revoke this specific consent. I have
11fully explained that if the specified person or persons adopt
12the child, by signing this consent this parent is irrevocably
13and permanently relinquishing all parental rights to the child,
14and this parent has stated that such is (her)(his) intention
15and desire.
16    Dated (insert date).
17    ...............................
18    Signature
19    (5) If a consent to adoption by a specified person or
20persons is executed in this form, the following provisions
21shall apply. The consent shall be valid only if that specified
22person or persons adopt the child. The consent shall be
23voidable after one year if:
24        (a) the specified person or persons do not file a
25    petition to adopt the child within one year after the
26    consent is signed and the parent files a timely motion to

 

 

HB5062- 35 -LRB097 18015 AJO 63238 b

1    revoke this consent. If this motion is filed before the
2    filing of the petition for adoption the court shall revoke
3    this consent; or
4        (b) a court denies the adoption petition; or
5        (c) the Department of Children and Family Services
6    Guardianship Administrator determines that the specified
7    person or persons will not or cannot complete the adoption,
8    or in the best interests of the child should not adopt the
9    child.
10    Within 30 days of the consent becoming void, the Department
11of Children and Family Services Guardianship Administrator
12shall make good faith attempts to notify the parent in writing
13and shall give written notice to the court and all additional
14parties in writing that the adoption has not occurred or will
15not occur and that the consent is void. If the adoption by a
16specified person or persons does not occur, no proceeding for
17termination of parental rights shall be brought unless the
18biological parent who executed the consent to adoption by a
19specified person or persons has been notified of the proceeding
20pursuant to Section 7 of this Act or subsection (4) of Section
212-13 of the Juvenile Court Act of 1987. The parent shall not
22need to take further action to revoke the consent if the
23specified adoption does not occur, notwithstanding the
24provisions of Section 11 of this Act.
25    (6) The Department of Children and Family Services is
26authorized to promulgate rules necessary to implement this

 

 

HB5062- 36 -LRB097 18015 AJO 63238 b

1subsection O.
2    (7) The Department shall collect and maintain data
3concerning the efficacy of specific consents. This data shall
4include the number of specific consents executed and their
5outcomes, including but not limited to the number of children
6adopted pursuant to the consents, the number of children for
7whom adoptions are not completed, and the reason or reasons why
8the adoptions are not completed.
9    P. If the person signing a consent is incarcerated or
10detained in a correctional facility, prison, jail, detention
11center, or other comparable institution, either in this State
12or any other jurisdiction, the execution of such consent may be
13acknowledged before social service personnel of such
14institution, or before a person designated by a court of
15competent jurisdiction.
16    Q. A consent may be acknowledged telephonically, via
17audiovisual connection, or other electronic means, provided
18that a court of competent jurisdiction has entered an order
19approving the execution of the consent in such manner and has
20designated an individual to be physically present with the
21parent executing such consent in order to verify the identity
22of the parent.
23    R. An agency whose representative is acknowledging a
24consent pursuant to this Section shall be a public child
25welfare agency, or a child welfare agency, or a child placing
26agency that is authorized or licensed in the State or

 

 

HB5062- 37 -LRB097 18015 AJO 63238 b

1jurisdiction in which the consent is signed.
2    S. The form of waiver by a putative or legal father of a
3born or unborn child shall be substantially as follows:
 
4
FINAL AND IRREVOCABLE
5
WAIVER OF PARENTAL RIGHTS OF PUTATIVE OR LEGAL FATHER

 
6    I, .................... , state under oath or affirm as
7follows:
8        1. That the biological mother ............... has
9    named me as a possible biological or legal father of her
10    minor child who was born, or is expected to be born on
11    ..........., ......, in the City/Town of........., State
12    of ...........
13        2. That I understand that the biological mother
14    ............. intends to or has placed the child for
15    adoption.
16        3. That I reside at ................, in the City/Town
17    of..........., State of ................
18        4. That I am ................ years of age and my date
19    of birth is ..............., .............
20        5. That I (select one):
21            ..... am married to the biological mother.
22            ..... am not married to the biological mother and
23        have not been married to the biological mother within
24        300 days before the child's birth or expected date of

 

 

HB5062- 38 -LRB097 18015 AJO 63238 b

1        child's birth.
2            ..... am not currently married to the biological
3        mother, but was married to the biological mother,
4        within 300 days before the child's birth or expected
5        date of child's birth.
6        6. That I (select one):
7            ..... neither admit nor deny that I am the
8        biological father of the child.
9            ..... deny that I am the biological father of the
10        child.
11        7. That I hereby agree to the termination of my
12    parental rights, if any, without further notice to me of
13    any proceeding for the adoption of the minor child, even if
14    I have taken any action to establish parental rights or
15    take any such action in the future including registering
16    with any putative father registry.
17        8. That I understand that by signing this Waiver I do
18    irrevocably and permanently give up all custody and other
19    parental rights I may have to such child.
20        9. That I understand that this Waiver is FINAL AND
21    IRREVOCABLE and that I am permanently barred from
22    contesting any proceeding for the adoption of the child
23    after I sign this Waiver.
24        10. That I waive any further service of summons or
25    other pleadings in any proceeding to terminate parental
26    rights, if any to this child, or any proceeding for

 

 

HB5062- 39 -LRB097 18015 AJO 63238 b

1    adoption of this child.
2        11. That I understand that if a final judgment or order
3    of adoption for this child is not entered, then any
4    parental rights or responsibilities that I may have remain
5    intact.
6        12. That I have read and understand the above and that
7    I am signing it as my free and voluntary act.
 
8    Dated: ................... , ..............
9    ...........................................
10    Signature
 
11
OATH
12I have been duly sworn and I state under oath that I have read
13and understood this Final and Irrevocable Waiver of Parental
14Rights of Putative or Legal Father. The facts contained in it
15are true and correct to the best of my knowledge. I have signed
16this document as my free and voluntary act in order to
17facilitate the adoption of the child.
 
18..............................
19Signature
 
20Signed and Sworn before me on
21this ............ day
22of ..........., 20....
 

 

 

HB5062- 40 -LRB097 18015 AJO 63238 b

1...................
2Notary Public
3(Source: P.A. 96-601, eff. 8-21-09; 96-1461, eff. 1-1-11;
497-493, eff. 8-22-11.)