HB5062 EngrossedLRB097 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.
3Nothing in the provisions of the preceding sentence stating
4that service of process need not be directed to a minor
5defendant under 14 years of age for whom a guardian ad litem
6has been or will be appointed is intended to override any
7provision of this Act which relates to information to which an
8adopted person is entitled under Section 18.1 of this Act. Any
9party defendant who is of age of 14 years or upward may waive
10service of process by entering an appearance in writing. The
11form to be used for publication shall be substantially as
12follows: "ADOPTION NOTICE - STATE OF ILLINOIS, County of ....,
13ss. - Circuit Court of .... County. In the matter of the
14Petition for the Adoption of ...., a ..male child. Adoption No.
15..... To-- .... (whom it may concern or the named parent) Take
16notice that a petition was filed in the Circuit Court of ....
17County, Illinois, for the adoption of a child named ..... Now,
18therefore, unless you ...., and all whom it may concern, file
19your answer to the Petition in the action or otherwise file
20your appearance therein, in the said Circuit Court of ....,
21County, Room ...., ...., in the City of ...., Illinois, on or
22before the .... day of ...., a default may be entered against
23you at any time after that day and a judgment entered in
24accordance with the prayer of said Petition. Dated, ....,
25Illinois, .... ...., Clerk. (Name and address of attorney for
26petitioners.)

 

 

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1    B. A minor defendant who has been served in accordance with
2this Section may be defaulted in the same manner as any other
3defendant.
4    C. Notwithstanding any inconsistent provision of this or
5any other law, and in addition to the notice requirements of
6any law pertaining to persons other than those specified in
7this subsection, the persons entitled to notice that a petition
8has been filed under Section 5 of this Act shall include:
9        (a) any person adjudicated by a court in this State to
10    be the father of the child;
11        (b) any person adjudicated by a court of another state
12    or territory of the United States to be the father of the
13    child, when a certified copy of the court order has been
14    filed with the Putative Father Registry under Section 12.1
15    of this Act;
16        (c) any person who at the time of the filing of the
17    petition is registered in the Putative Father Registry
18    under Section 12.1 of this Act as the putative father of
19    the child;
20        (d) any person who is recorded on the child's birth
21    certificate as the child's father;
22        (e) any person who is openly living with the child or
23    the child's mother at the time the proceeding is initiated
24    and who is holding himself out to be the child's father;
25        (f) any person who has been identified as the child's
26    father by the mother in a written, sworn statement,

 

 

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1    including an Affidavit of Identification as specified
2    under Section 11 of this Act;
3        (g) any person who was married to the child's mother on
4    the date of the child's birth or within 300 days prior to
5    the child's birth.
6    The sole purpose of notice under this Section shall be to
7enable the person receiving notice to appear in the adoption
8proceedings to present evidence to the court relevant to
9whether the consent or surrender of the person to the adoption
10is required pursuant to Section 8 of this Act. If the court
11determines that the consent or surrender of the person is not
12required pursuant to Section 8, then the person shall not be
13entitled to participate in the proceedings or to any further
14notice of the proceedings.
15(Source: P.A. 94-530, eff. 1-1-06.)
 
16    (750 ILCS 50/10)  (from Ch. 40, par. 1512)
17    Sec. 10. Forms of consent and surrender; execution and
18acknowledgment thereof.
19    A. The form of consent required for the adoption of a born
20child shall be substantially as follows:
21
FINAL AND IRREVOCABLE CONSENT TO ADOPTION
22    I, ...., (relationship, e.g., mother, father, relative,
23guardian) of ...., a ..male child, state:
24    That such child was born on .... at ....
25    That I reside at ...., County of .... and State of ....

 

 

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1    That I am of the age of .... years.
2    That I hereby enter my appearance in this proceeding and
3waive service of summons on me.
4    That I hereby acknowledge that I have been provided with a
5copy of the Birth Parent Rights and Responsibilities-Private
6Form before signing this Consent and that I have had time to
7read, or have had read to me, this Form. I understand that if I
8do not receive any of the rights as described in this Form, it
9shall not constitute a basis to revoke this Final and
10Irrevocable Consent.
11    That I do hereby consent and agree to the adoption of such
12child.
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 such child.
16    That I understand such child will be placed for adoption
17and that I cannot under any circumstances, after signing this
18document, change my mind and revoke or cancel this consent or
19obtain or recover custody or any other rights over such child.
20That I have read and understand the above and I am signing it
21as my free and voluntary act.
22    Dated (insert date).
23.........................
 
24    If under Section 8 the consent of more than one person is
25required, then each such person shall execute a separate

 

 

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

 

 

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1understand that if I do not receive any of my rights as
2described in said Form, it shall not constitute a basis to
3revoke this Final and Irrevocable Consent to Adoption by a
4Specified Person.
5    6. That I do hereby consent and agree to the adoption of
6such child by .... (specified persons) only.
7    7. That I wish to and understand that upon signing this
8consent I do irrevocably and permanently give up all custody
9and other parental rights I have to such child if such child is
10adopted by .... (specified person or persons). I hereby
11transfer all of my rights to the custody, care and control of
12such child to ............................. (specified person
13or persons).
14    8. That I understand such child will be adopted by
15....................... (specified person or persons) and that
16I cannot under any circumstances, after signing this document,
17change my mind and revoke or cancel this consent or obtain or
18recover custody or any other rights over such child if
19............................ (specified person or persons)
20adopt(s) such child; PROVIDED that each specified person has
21filed or shall file, within 60 days from the date hereof, a
22petition for the adoption of such child.
23    9. That if the specified person or persons designated
24herein do not file a petition for adoption within the
25time-frame specified above, or, if said petition for adoption
26is filed within the time-frame specified above but the adoption

 

 

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1petition is dismissed with prejudice or the adoption proceeding
2is otherwise concluded without an order declaring the child to
3be the adopted child of the specified person or persons, then I
4understand that I will receive written notice of such
5circumstances within 10 business days of their occurrence. I
6understand that the notice will be directed to me using the
7contact information I have provided in this consent. I
8understand that I will have 10 business days from the date that
9the written notice is sent to me to respond, within which time
10I may request the Court to declare this consent voidable and
11return the child to me. I further understand that the Court
12will make the final decision of whether or not the child will
13be returned to me. If I do not make such request within 10
14business days of the date of the notice, then I expressly waive
15any other notice or service of process in any legal proceeding
16for the adoption of the child.
17    10. That I expressly acknowledge that nothing in this
18Consent impairs the validity and absolute finality of this
19Consent under any circumstance other than those described in
20paragraph 9 of this Consent.
21    11. That I understand that I have a remaining duty and
22obligation to keep .............. (insert name and address of
23the attorney for the specified person or persons) informed of
24my current address or other preferred contact information until
25this adoption has been finalized. My failure to do so may
26result in the termination of my parental rights and the child

 

 

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1being placed for adoption in another home.
2    12. That I do expressly waive any other notice or service
3of process in any of the legal proceedings for the adoption of
4the child as long as the adoption proceeding by the specified
5person or persons is pending.
6    13. That I have read and understand the above and I am
7signing it as my free and voluntary act.
8    14. That I acknowledge that this consent is valid even if
9the specified person or persons separate or divorce or one of
10the specified persons dies prior to the entry of the final
11judgment for adoption.
12    Dated (insert date).
13    .............................................
14    Signature of parent.
15    .............................................
16    Address of parent.
17    .............................................
18    Phone number(s) of parent.
19    .............................................
20    Personal email(s) of parent.
21    .............................................
22    (3) The form of the certificate of acknowledgement for a
23Final and Irrevocable Consent for Adoption by a Specified
24Person or Persons: Non-DCFS Case shall be substantially as
25follows:
 

 

 

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1STATE OF ..............)
2                       ) SS.
3COUNTY OF .............)
4    I, .................... (Name of Judge or other person),
5..................... (official title, name, and address),
6certify that ............., personally known to me to be the
7same person whose name is subscribed to the foregoing Final and
8Irrevocable Consent for Adoption by a Specified Person or
9Persons; non-DCFS case, appeared before me this day in person
10and acknowledged that (she)(he) signed and delivered the
11consent as (her)(his) free and voluntary act, for the specified
12purpose. I am further satisfied that, before signing this
13Consent, ........ has read, or has had read to him or her, the
14Birth Parent Rights and Responsibilities-Private Form.
15    A-2. Birth Parent Rights and Responsibilities-Private
16Form. The Birth Parent Rights and Responsibilities-Private
17Form must be read by, or have been read to, any person
18executing a Final and Irrevocable Consent to Adoption under
19subsection A, a Final and Irrevocable Consent to Adoption by a
20Specified Person or Persons: Non-DCFS Case under subsection
21A-1, or a Consent to Adoption of Unborn Child under subsection
22B prior to the execution of said Consent. The form of the Birth
23Parent Rights and Responsibilities-Private Form shall be
24substantially as follows:
25
Birth Parent Rights and Responsibilities-Private Form
26    As a birth parent in the State of Illinois, you have the

 

 

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

 

 

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

 

 

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1adoption.
2    2. To voluntarily provide all known medical, background,
3and family information about yourself and your immediate family
4to your child's prospective adoptive parents or their attorney.
5For the health of your child, you are strongly encouraged, but
6not required, to provide all known medical, background, and
7family history information about yourself and your family to
8your child's prospective adoptive parents or their attorney.
9    3. (Birth mothers only) To accurately complete an Affidavit
10of Identification, which identifies the father of the child
11when known, with the understanding that a birth mother has a
12right to decline to identify the birth father.
13    4. To not accept financial support or reimbursement of
14pregnancy related expenses simultaneously from more than one
15source.
16    B. The form of consent required for the adoption of an
17unborn child shall be substantially as follows:
18
CONSENT TO ADOPTION OF UNBORN CHILD
19    I, ...., state:
20    That I am the father of a child expected to be born on or
21about .... to .... (name of mother).
22    That I reside at .... County of ...., and State of .....
23    That I am of the age of .... years.
24    That I hereby enter my appearance in such adoption
25proceeding and waive service of summons on me.
26    That I hereby acknowledge that I have been provided with a

 

 

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1copy of the Birth Parent Rights and Responsibilities-Private
2Form before signing this Consent, and that I have had time to
3read, or have had read to me, this Form. I understand that if I
4do not receive any of the rights as described in this Form, it
5shall not constitute a basis to revoke this Consent to Adoption
6of Unborn Child.
7    That I do hereby consent and agree to the adoption of such
8child, and that I have not previously executed a consent or
9surrender with respect to such child.
10    That I wish to and do understand that by signing this
11consent I do irrevocably and permanently give up all custody
12and other parental rights I have to such child, except that I
13have the right to revoke this consent by giving written notice
14of my revocation not later than 72 hours after the birth of the
15child.
16    That I understand such child will be placed for adoption
17and that, except as hereinabove provided, I cannot under any
18circumstances, after signing this document, change my mind and
19revoke or cancel this consent or obtain or recover custody or
20any other rights over such child.
21    That I have read and understand the above and I am signing
22it as my free and voluntary act.
23    Dated (insert date).
24........................
25    B-5. (1) The parent of a child may execute a consent to
26standby adoption by a specified person or persons. A consent

 

 

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1under this subsection B-5 shall be acknowledged by a parent
2pursuant to subsection H and subsection K of this Section. The
3form of consent required for the standby adoption of a born
4child effective at a future date when the consenting parent of
5the child dies or requests that a final judgment of adoption be
6entered shall be substantially as follows:
7
FINAL AND IRREVOCABLE CONSENT
8
TO STANDBY ADOPTION
9    I, ..., (relationship, e.g. mother or father) of ...., a
10..male child, state:
11    That the child was born on .... at .....
12    That I reside at ...., County of ...., and State of .....
13    That I am of the age of .... years.
14    That I hereby enter my appearance in this proceeding and
15waive service of summons on me in this action only.
16    That I do hereby consent and agree to the standby adoption
17of the child, and that I have not previously executed a consent
18or surrender with respect to the child.
19    That I wish to and understand that by signing this consent
20I do irrevocably and permanently give up all custody and other
21parental rights I have to the child, effective upon (my death)
22(the child's other parent's death) or upon (my) (the other
23parent's) request for the entry of a final judgment for
24adoption if ..... (specified person or persons) adopt my child.
25    That I understand that until (I die) (the child's other
26parent dies), I retain all legal rights and obligations

 

 

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

 

 

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1paragraphs in substantially the following form:
2    If .... (specified persons) obtain a judgment of
3dissolution of marriage before the judgment for adoption is
4entered, then ..... (specified person) shall adopt my child. I
5understand that I cannot change my mind and revoke this consent
6or obtain or recover custody of my child if ..... (specified
7persons) obtain a judgment of dissolution of marriage and .....
8(specified person) adopts my child. I understand that I cannot
9change my mind and revoke this consent if ...... (specified
10persons) obtain a judgment of dissolution of marriage before
11the adoption is final. I understand that this consent to
12adoption has no effect on who will get custody of my child if
13..... (specified persons) obtain a judgment of dissolution of
14marriage after the adoption is final. I understand that if
15either ..... (specified persons) dies before the petition to
16adopt my child is granted, then the surviving person may adopt
17my child. I understand that I cannot change my mind and revoke
18this consent or obtain or recover custody of my child if the
19surviving person adopts my child.
20    A consent to standby adoption by specified persons on this
21form shall have no effect on a court's determination of custody
22or visitation under the Illinois Marriage and Dissolution of
23Marriage Act if the marriage of the specified persons is
24dissolved before the adoption is final.
25    (3) The form of the certificate of acknowledgement for a
26Final and Irrevocable Consent for Standby Adoption shall be

 

 

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

 

 

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1form, the consent shall be valid only if the specified person
2or persons adopt the child. The consent shall be void if:
3    (a) the specified person or persons do not file a petition
4for standby adoption of the child; or
5    (b) a court denies the standby adoption petition.
6    The parent shall not need to take further action to revoke
7the consent if the standby adoption by the specified person or
8persons does not occur, notwithstanding the provisions of
9Section 11 of this Act.
10    C. The form of surrender to any agency given by a parent of
11a born child who is to be subsequently placed for adoption
12shall be substantially as follows and shall contain such other
13facts and statements as the particular agency shall require.
14
FINAL AND IRREVOCABLE SURRENDER
15
FOR PURPOSES OF 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 do hereby surrender and entrust the entire custody
22and control of such child to the .... (the "Agency"), a
23(public) (licensed) child welfare agency with its principal
24office in the City of ...., County of .... and State of ....,
25for the purpose of enabling it to care for and supervise the
26care of such child, to place such child for adoption and to

 

 

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1consent to the legal adoption of such child.
2    That I hereby grant to the Agency full power and authority
3to place such child with any person or persons it may in its
4sole discretion select to become the adopting parent or parents
5and to consent to the legal adoption of such child by such
6person or persons; and to take any and all measures which, in
7the judgment of the Agency, may be for the best interests of
8such child, including authorizing medical, surgical and dental
9care and treatment including inoculation and anaesthesia for
10such child.
11    That I wish to and understand that by signing this
12surrender I do irrevocably and permanently give up all custody
13and other parental rights I have to such child.
14    That I understand I cannot under any circumstances, after
15signing this surrender, change my mind and revoke or cancel
16this surrender or obtain or recover custody or any other rights
17over such child.
18    That I have read and understand the above and I am signing
19it as my free and voluntary act.
20    Dated (insert date).
21........................
22    C-5. The form of a Final and Irrevocable Designated
23Surrender for Purposes of Adoption to any agency given by a
24parent of a born child who is to be subsequently placed for
25adoption is to be used by legal parents only. The form shall be
26substantially as follows and shall contain such other facts and

 

 

HB5062 Engrossed- 22 -LRB097 18015 AJO 63238 b

1statements as the particular agency shall require:
2
FINAL AND IRREVOCABLE DESIGNATED SURRENDER
3
FOR PURPOSES OF ADOPTION
4    I, .... (relationship, e.g., mother, father, relative,
5guardian) of ...., a ..male child, state:
6    1. That such child was born on ...., at .....
7    2. That I reside at ...., County of ...., and State of
8.....
9    3. That I am of the age of .... years.
10    4. That I do hereby surrender and entrust the entire
11custody and control of such child to the .... (the "Agency"), a
12(public) (licensed) child welfare agency with its principal
13office in the City of ...., County of .... and State of ....,
14for the purpose of enabling it to care for and supervise the
15care of such child, to place such child for adoption with
16............................. (specified person or persons)
17and to consent to the legal adoption of such child and to take
18any and all measures which, in the judgment of the Agency, may
19be for the best interests of such child, including authorizing
20medical, surgical and dental care and treatment including
21inoculation and anesthesia for such child.
22    5. That I wish to and understand that by signing this
23surrender I do irrevocably and permanently give up all custody
24and other parental rights I have to such child.
25    6. That if the petition for adoption is not filed by the
26specified person or persons designated herein or, if the

 

 

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1petition for adoption is filed but the adoption petition is
2dismissed with prejudice or the adoption proceeding is
3otherwise concluded without an order declaring the child to be
4the adopted child of each specified person, then I understand
5that the Agency will provide notice to me within 10 business
6days and that such notice will be directed to me using the
7contact information I have provided to the Agency. I understand
8that I will have 10 business days from the date that the Agency
9sends me its notice to respond, within which time I may choose
10to designate other adoptive parent(s). However, I acknowledge
11that the Agency has full power and authority to place the child
12for adoption with any person or persons it may in its sole
13discretion select to become the adopting parent or parents and
14to consent to the legal adoption of the child by such person or
15persons.
16    7. That I acknowledge that this surrender is valid even if
17the specified persons separate or divorce or one of the
18specified persons dies prior to the entry of the final judgment
19for adoption.
20    8. That I expressly acknowledge that the above paragraphs 6
21and 7 do not impair the validity and absolute finality of this
22surrender under any circumstance.
23    9. That I understand that I have a remaining obligation to
24keep the Agency informed of my current contact information
25until the adoption of the child has been finalized if I wish to
26be notified in the event the adoption by the specified

 

 

HB5062 Engrossed- 24 -LRB097 18015 AJO 63238 b

1person(s) cannot proceed.
2    10. That I understand I cannot under any circumstances,
3after signing this surrender, change my mind and revoke or
4cancel this surrender or obtain or recover custody or any other
5rights over such child.
6    11. That I have read and understand the above and I am
7signing it as my free and voluntary act.
8    Dated (insert date).
9..............................
10    D. The form of surrender to an agency given by a parent of
11an unborn child who is to be subsequently placed for adoption
12shall be substantially as follows and shall contain such other
13facts and statements as the particular agency shall require.
14
SURRENDER OF UNBORN CHILD FOR
15
PURPOSES OF ADOPTION
16    I, .... (father), state:
17    That I am the father of a child expected to be born on or
18about .... to .... (name of mother).
19    That I reside at ...., County of ...., and State of .....
20    That I am of the age of .... years.
21    That I do hereby surrender and entrust the entire custody
22and control of such child to the .... (the "Agency"), a
23(public) (licensed) child welfare agency with its principal
24office in the City of ...., County of .... and State of ....,
25for the purpose of enabling it to care for and supervise the
26care of such child, to place such child for adoption and to

 

 

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1consent to the legal adoption of such child, and that I have
2not previously executed a consent or surrender with respect to
3such child.
4    That I hereby grant to the Agency full power and authority
5to place such child with any person or persons it may in its
6sole discretion select to become the adopting parent or parents
7and to consent to the legal adoption of such child by such
8person or persons; and to take any and all measures which, in
9the judgment of the Agency, may be for the best interests of
10such child, including authorizing medical, surgical and dental
11care and treatment, including inoculation and anaesthesia for
12such child.
13    That I wish to and understand that by signing this
14surrender I do irrevocably and permanently give up all custody
15and other parental rights I have to such child.
16    That I understand I cannot under any circumstances, after
17signing this surrender, change my mind and revoke or cancel
18this surrender or obtain or recover custody or any other rights
19over such child, except that I have the right to revoke this
20surrender by giving written notice of my revocation not later
21than 72 hours after the birth of such child.
22    That I have read and understand the above and I am signing
23it as my free and voluntary act.
24    Dated (insert date).
25........................
26    E. The form of consent required from the parents for the

 

 

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

 

 

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1appointment and the authority of the guardian to execute such
2consent.
3    H. A consent (other than that given by an agency, or
4guardian of the person of the child sought to be adopted who
5was appointed by a court of competent jurisdiction) shall be
6acknowledged by a parent before a judge of a court of competent
7jurisdiction or, except as otherwise provided in this Act,
8before a representative of an agency, or before a person, other
9than the attorney for the prospective adoptive parent or
10parents, designated by a court of competent jurisdiction.
11    I. A surrender, or any other document equivalent to a
12surrender, by which a child is surrendered to an agency shall
13be acknowledged by the person signing such surrender, or other
14document, before a judge of a court of competent jurisdiction,
15or, except as otherwise provided in this Act, before a
16representative of an agency, or before a person designated by a
17court of competent jurisdiction.
18    J. The form of the certificate of acknowledgment for a
19consent, a surrender, or any other document equivalent to a
20surrender, shall be substantially as follows:
21STATE OF ....)
22             ) SS.
23COUNTY OF ...)
24    I, .... (Name of judge or other person), .... (official
25title, name and location of court or status or position of
26other person), certify that ...., personally known to me to be

 

 

HB5062 Engrossed- 28 -LRB097 18015 AJO 63238 b

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

 

 

HB5062 Engrossed- 29 -LRB097 18015 AJO 63238 b

1acknowledged that (she) (he) signed such certificate as (her)
2(his) free and voluntary act and that the statements made in
3the certificate are true.
4    Dated (insert date).
5    
Signature ...................... Notary Public
6
(official seal)

 
7    There shall be attached a certificate of magistracy, or
8other comparable proof of office of the notary public
9satisfactory to the court, to a consent signed and acknowledged
10in another state.
11    L. A surrender or consent executed and acknowledged outside
12of this State, either in accordance with the law of this State
13or in accordance with the law of the place where executed, is
14valid.
15    M. Where a consent or a surrender is signed in a foreign
16country, the execution of such consent shall be acknowledged or
17affirmed in a manner conformable to the law and procedure of
18such country.
19    N. If the person signing a consent or surrender is in the
20military service of the United States, the execution of such
21consent or surrender may be acknowledged before a commissioned
22officer and the signature of such officer on such certificate
23shall be verified or acknowledged before a notary public or by
24such other procedure as is then in effect for such division or
25branch of the armed forces.

 

 

HB5062 Engrossed- 30 -LRB097 18015 AJO 63238 b

1    O. (1) The parent or parents of a child in whose interests
2a petition under Section 2-13 of the Juvenile Court Act of 1987
3is pending may, with the approval of the designated
4representative of the Department of Children and Family
5Services, execute a consent to adoption by a specified person
6or persons:
7        (a) in whose physical custody the child has resided for
8    at least 6 months; or
9        (b) in whose physical custody at least one sibling of
10    the child who is the subject of this consent has resided
11    for at least 6 months, and the child who is the subject of
12    this consent is currently residing in this foster home; or
13        (c) in whose physical custody a child under one year of
14    age has resided for at least 3 months.
15A consent under this subsection O shall be acknowledged by a
16parent pursuant to subsection H and subsection K of this
17Section.
18    (2) The consent to adoption by a specified person or
19persons shall have the caption of the proceeding in which it is
20to be filed and shall be substantially as follows:
21
FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY
22
A SPECIFIED PERSON OR PERSONS: DCFS CASE
23    I, ......................................, the
24.................. (mother or father) of a ....male child,
25state:
26         My child ............................ (name of child)

 

 

HB5062 Engrossed- 31 -LRB097 18015 AJO 63238 b

1    was born on (insert date) at .................... Hospital
2    in ................ County, State of ...............
3         I reside at ......................, County of
4    ............. and State of ..............
5         I, ..........................., am .... years old.
6         I enter my appearance in this action to adopt my child
7    by the person or persons specified herein by me and waive
8    service of summons on me in this action only.
9         I consent to the adoption of my child by
10    ............................. (specified person or
11    persons) only.
12         I wish to sign this consent and I understand that by
13    signing this consent I irrevocably and permanently give up
14    all parental rights I have to my child if my child is
15    adopted by ............................. (specified person
16    or persons).
17         I understand my child will be adopted by
18    ............................. (specified person or
19    persons) only and that I cannot under any circumstances,
20    after signing this document, change my mind and revoke or
21    cancel this consent or obtain or recover custody or any
22    other rights over my child if ............................
23    (specified person or persons) adopt my child.
24         I understand that this consent to adoption is valid
25    only if the petition to adopt is filed within one year from
26    the date that I sign it and that if .......................

 

 

HB5062 Engrossed- 32 -LRB097 18015 AJO 63238 b

1    (specified person or persons), for any reason, cannot or
2    will not file a petition to adopt my child within that one
3    year period or if their adoption petition is denied, then
4    this consent will be voidable after one year upon the
5    timely filing of my motion. If I file this motion before
6    the filing of the petition for adoption, I understand that
7    the court shall revoke this specific consent. I have the
8    right to notice of any other proceeding that could affect
9    my parental rights, except for the proceeding for
10    ............. (specified person or persons) to adopt my
11    child.
12         I have read and understand the above and I am signing
13    it as my free and voluntary act.
14        Dated (insert date).
15        .............................................
16        Signature of parent
17    (3) If the parent consents to an adoption by 2 specified
18persons, then the form shall contain 2 additional paragraphs in
19substantially the following form:
20         If ............... (specified persons) get a divorce
21    before the petition to adopt my child is granted, then
22    .......... (specified person) shall adopt my child. I
23    understand that I cannot change my mind and revoke this
24    consent or obtain or recover custody over my child if
25    ............. (specified persons) divorce and
26    ............. (specified person) adopts my child. I

 

 

HB5062 Engrossed- 33 -LRB097 18015 AJO 63238 b

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

 

 

HB5062 Engrossed- 34 -LRB097 18015 AJO 63238 b

1..................... (official title, name, and address),
2certify that ............., personally known to me to be the
3same person whose name is subscribed to the foregoing Final and
4Irrevocable Consent for Adoption by a Specified Person or
5Persons, appeared before me this day in person and acknowledged
6that (she)(he) signed and delivered the consent as (her)(his)
7free and voluntary act, for the specified purpose.
8    I have fully explained that this consent to adoption is
9valid only if the petition to adopt is filed within one year
10from the date that it is signed, and that if the specified
11person or persons, for any reason, cannot or will not adopt the
12child or if the adoption petition is denied, then this consent
13will be voidable after one year upon the timely filing of a
14motion by the parent to revoke the consent. I explained that if
15this motion is filed before the filing of the petition for
16adoption, the court shall revoke this specific consent. I have
17fully explained that if the specified person or persons adopt
18the child, by signing this consent this parent is irrevocably
19and permanently relinquishing all parental rights to the child,
20and this parent has stated that such is (her)(his) intention
21and desire.
22    Dated (insert date).
23    ...............................
24    Signature
25    (5) If a consent to adoption by a specified person or
26persons is executed in this form, the following provisions

 

 

HB5062 Engrossed- 35 -LRB097 18015 AJO 63238 b

1shall apply. The consent shall be valid only if that specified
2person or persons adopt the child. The consent shall be
3voidable after one year if:
4        (a) the specified person or persons do not file a
5    petition to adopt the child within one year after the
6    consent is signed and the parent files a timely motion to
7    revoke this consent. If this motion is filed before the
8    filing of the petition for adoption the court shall revoke
9    this consent; or
10        (b) a court denies the adoption petition; or
11        (c) the Department of Children and Family Services
12    Guardianship Administrator determines that the specified
13    person or persons will not or cannot complete the adoption,
14    or in the best interests of the child should not adopt the
15    child.
16    Within 30 days of the consent becoming void, the Department
17of Children and Family Services Guardianship Administrator
18shall make good faith attempts to notify the parent in writing
19and shall give written notice to the court and all additional
20parties in writing that the adoption has not occurred or will
21not occur and that the consent is void. If the adoption by a
22specified person or persons does not occur, no proceeding for
23termination of parental rights shall be brought unless the
24biological parent who executed the consent to adoption by a
25specified person or persons has been notified of the proceeding
26pursuant to Section 7 of this Act or subsection (4) of Section

 

 

HB5062 Engrossed- 36 -LRB097 18015 AJO 63238 b

12-13 of the Juvenile Court Act of 1987. The parent shall not
2need to take further action to revoke the consent if the
3specified adoption does not occur, notwithstanding the
4provisions of Section 11 of this Act.
5    (6) The Department of Children and Family Services is
6authorized to promulgate rules necessary to implement this
7subsection O.
8    (7) The Department shall collect and maintain data
9concerning the efficacy of specific consents. This data shall
10include the number of specific consents executed and their
11outcomes, including but not limited to the number of children
12adopted pursuant to the consents, the number of children for
13whom adoptions are not completed, and the reason or reasons why
14the adoptions are not completed.
15    P. If the person signing a consent is incarcerated or
16detained in a correctional facility, prison, jail, detention
17center, or other comparable institution, either in this State
18or any other jurisdiction, the execution of such consent may be
19acknowledged before social service personnel of such
20institution, or before a person designated by a court of
21competent jurisdiction.
22    Q. A consent may be acknowledged telephonically, via
23audiovisual connection, or other electronic means, provided
24that a court of competent jurisdiction has entered an order
25approving the execution of the consent in such manner and has
26designated an individual to be physically present with the

 

 

HB5062 Engrossed- 37 -LRB097 18015 AJO 63238 b

1parent executing such consent in order to verify the identity
2of the parent.
3    R. An agency whose representative is acknowledging a
4consent pursuant to this Section shall be a public child
5welfare agency, or a child welfare agency, or a child placing
6agency that is authorized or licensed in the State or
7jurisdiction in which the consent is signed.
8    S. The form of waiver by a putative or legal father of a
9born or unborn child shall be substantially as follows:
 
10
FINAL AND IRREVOCABLE
11
WAIVER OF PARENTAL RIGHTS OF PUTATIVE OR LEGAL FATHER

 
12    I, .................... , state under oath or affirm as
13follows:
14        1. That the biological mother ............... has
15    named me as a possible biological or legal father of her
16    minor child who was born, or is expected to be born on
17    ..........., ......, in the City/Town of........., State
18    of ...........
19        2. That I understand that the biological mother
20    ............. intends to or has placed the child for
21    adoption.
22        3. That I reside at ................, in the City/Town
23    of..........., State of ................
24        4. That I am ................ years of age and my date

 

 

HB5062 Engrossed- 38 -LRB097 18015 AJO 63238 b

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

 

 

HB5062 Engrossed- 39 -LRB097 18015 AJO 63238 b

1    IRREVOCABLE and that I am permanently barred from
2    contesting any proceeding for the adoption of the child
3    after I sign this Waiver.
4        10. That I waive any further service of summons or
5    other pleadings in any proceeding to terminate parental
6    rights, if any to this child, or any proceeding for
7    adoption of this child.
8        11. That I understand that if a final judgment or order
9    of adoption for this child is not entered, then any
10    parental rights or responsibilities that I may have remain
11    intact.
12        12. That I have read and understand the above and that
13    I am signing it as my free and voluntary act.
 
14    Dated: ................... , ..............
15    ...........................................
16    Signature
 
17
OATH
18I have been duly sworn and I state under oath that I have read
19and understood this Final and Irrevocable Waiver of Parental
20Rights of Putative or Legal Father. The facts contained in it
21are true and correct to the best of my knowledge. I have signed
22this document as my free and voluntary act in order to
23facilitate the adoption of the child.
 

 

 

HB5062 Engrossed- 40 -LRB097 18015 AJO 63238 b

1..............................
2Signature
 
3Signed and Sworn before me on
4this ............ day
5of ..........., 20....
 
6...................
7Notary Public
8(Source: P.A. 96-601, eff. 8-21-09; 96-1461, eff. 1-1-11;
997-493, eff. 8-22-11.)