Full Text of HB1699 97th General Assembly
HB1699 97TH GENERAL ASSEMBLY |
| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012 HB1699 Introduced , by Rep. Sara Feigenholtz SYNOPSIS AS INTRODUCED: |
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750 ILCS 50/10 | from Ch. 40, par. 1512 |
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Amends the Adoption Act. Provides that one of the statutory forms that is used for purposes of an agency adoption shall only be used by legal parents (instead of unspecified).
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| | A BILL FOR |
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| 1 | | AN ACT concerning civil law.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Adoption Act is amended by changing Section | 5 | | 10 as follows:
| 6 | | (750 ILCS 50/10) (from Ch. 40, par. 1512)
| 7 | | Sec. 10. Forms of consent and surrender; execution and
| 8 | | acknowledgment thereof. | 9 | | A. The form of consent required for the
adoption of a born | 10 | | child shall be substantially as follows:
| 11 | | FINAL AND IRREVOCABLE CONSENT TO ADOPTION
| 12 | | I, ...., (relationship, e.g., mother, father, relative, | 13 | | guardian)
of ...., a ..male child, state:
| 14 | | That such child was born on .... at ....
| 15 | | That I reside at ...., County of .... and State of ....
| 16 | | That I am of the age of .... years.
| 17 | | That I hereby enter my appearance in this proceeding and | 18 | | waive
service of summons on me.
| 19 | | That I hereby acknowledge that I have been provided with a | 20 | | copy of the Birth Parent Rights and Responsibilities-Private | 21 | | Form before signing this Consent and that I have had time to | 22 | | read, or have had read to me, this Form. I understand that if I | 23 | | do not receive any of the rights as described in this Form, it |
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| 1 | | shall not constitute a basis to revoke this Final and | 2 | | Irrevocable Consent. | 3 | | That I do hereby consent and agree to the adoption of such | 4 | | child.
| 5 | | That I wish to and understand that by signing this consent | 6 | | I do
irrevocably and permanently give up all custody and other | 7 | | parental
rights I have to such child.
| 8 | | That I understand such child will be placed for adoption | 9 | | and that I
cannot under any circumstances, after signing this | 10 | | document, change my
mind and revoke or cancel this consent or | 11 | | obtain or recover custody or
any other rights over such child. | 12 | | That I have read and understand the
above and I am signing it | 13 | | as my free and voluntary act.
| 14 | | Dated (insert date).
| 15 | | .........................
| 16 | | If under Section 8 the consent of more than one person is | 17 | | required,
then each such person shall execute a separate | 18 | | consent.
| 19 | | A-1. (1) The form of the Final and Irrevocable Consent to | 20 | | Adoption by a Specified Person or Persons: Non-DCFS Case set | 21 | | forth in this subsection A-1 is to be used by legal parents | 22 | | only. This form is not to be used in cases in which there is a | 23 | | pending petition under Section 2-13 of the Juvenile Court Act | 24 | | of 1987. | 25 | | (2) The form of the Final and Irrevocable Consent to |
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| 1 | | Adoption by a Specified Person or Persons in a non-DCFS case | 2 | | shall have the caption of the proceeding in which it is to be | 3 | | filed and shall be substantially as follows: | 4 | | FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY | 5 | | A SPECIFIED PERSON OR PERSONS; NON-DCFS CASE | 6 | | I, ...., (relationship, e.g., mother, father) of ...., a | 7 | | ..male child, state: | 8 | | 1. That such child was born on ...., at ....., City of ... | 9 | | and State of .... | 10 | | 2. That I reside at ...., County of .... and State of .... | 11 | | 3. That I am of the age of .... years. | 12 | | 4. That I hereby enter my appearance in this proceeding and | 13 | | waive service of summons on me. | 14 | | 5. That I hereby acknowledge that I have been provided a | 15 | | copy of the Birth Parent Rights and Responsibilities-Private | 16 | | Form before signing this Consent and that I have had time to | 17 | | read, or have had read to me, this Form and that I understand | 18 | | the Rights and Responsibilities described in this Form. I | 19 | | understand that if I do not receive any of my rights as | 20 | | described in said Form, it shall not constitute a basis to | 21 | | revoke this Final and Irrevocable Consent to Adoption by a | 22 | | Specified Person. | 23 | | 6. That I do hereby consent and agree to the adoption of | 24 | | such child by .... (specified persons) only. | 25 | | 7. That I wish to and understand that upon signing this | 26 | | consent I do irrevocably and permanently give up all custody |
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| 1 | | and other parental rights I have to such child if such child is | 2 | | adopted by .... (specified person or persons). I hereby | 3 | | transfer all of my rights to the custody, care and control of | 4 | | such child to ............................. (specified person | 5 | | or persons). | 6 | | 8. That I understand such child will be adopted by | 7 | | ....................... (specified person or persons) and that | 8 | | I cannot under any circumstances, after signing this document, | 9 | | change my mind and revoke or cancel this consent or obtain or | 10 | | recover custody or any other rights over such child if | 11 | | ............................ (specified person or persons) | 12 | | adopt(s) such child; PROVIDED that each specified person has | 13 | | filed or shall file, within 60 days from the date hereof, a | 14 | | petition for the adoption of such child. | 15 | | 9. That if the specified person or persons designated | 16 | | herein do not file a petition for adoption within the | 17 | | time-frame specified above, or, if said petition for adoption | 18 | | is filed within the time-frame specified above but the adoption | 19 | | petition is dismissed with prejudice or the adoption proceeding | 20 | | is otherwise concluded without an order declaring the child to | 21 | | be the adopted child of the specified person or persons, then I | 22 | | understand that I will receive written notice of such | 23 | | circumstances within 10 business days of their occurrence. I | 24 | | understand that the notice will be directed to me using the | 25 | | contact information I have provided in this consent. I | 26 | | understand that I will have 10 business days from the date that |
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| 1 | | the written notice is sent to me to respond, within which time | 2 | | I may request the Court to declare this consent voidable and | 3 | | return the child to me. I further understand that the Court | 4 | | will make the final decision of whether or not the child will | 5 | | be returned to me. If I do not make such request within 10 | 6 | | business days of the date of the notice, then I expressly waive | 7 | | any other notice or service of process in any legal proceeding | 8 | | for the adoption of the child. | 9 | | 10. That I expressly acknowledge that nothing in this | 10 | | Consent
impairs the validity and absolute finality of this
| 11 | | Consent under any circumstance other than those described in
| 12 | | paragraph 9 of this Consent. | 13 | | 11. That I understand that I have a remaining duty and
| 14 | | obligation to keep .............. (insert name and address of | 15 | | the attorney
for the specified person or persons) informed of | 16 | | my current
address or other preferred contact information until | 17 | | this adoption has been finalized. My failure to
do so may | 18 | | result in the termination of my parental rights and
the child | 19 | | being placed for adoption in another home. | 20 | | 12. That I do expressly waive any other notice or service | 21 | | of process in any of the legal proceedings for the adoption of | 22 | | the child as long as the adoption proceeding by the specified | 23 | | person or persons is pending. | 24 | | 13. That I have read and understand the above and I am | 25 | | signing it as my free and voluntary act. | 26 | | 14. That I acknowledge that this consent is valid even if |
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| 1 | | the specified person or persons separate or divorce or one of | 2 | | the specified persons dies prior to the entry of the final | 3 | | judgment for adoption. | 4 | | Dated (insert date). | 5 | | ............................................. | 6 | | Signature of parent. | 7 | | ............................................. | 8 | | Address of parent. | 9 | | ............................................. | 10 | | Phone number(s) of parent. | 11 | | ............................................. | 12 | | Personal email(s) of parent. | 13 | | ............................................. | 14 | | (3) The form of the certificate of acknowledgement for a | 15 | | Final and Irrevocable Consent for Adoption by a Specified | 16 | | Person or Persons: Non-DCFS Case shall be substantially as | 17 | | follows: | 18 | | STATE OF..............)
| 19 | | ) SS.
| 20 | | COUNTY OF.............) | 21 | | I, .................... (Name of Judge or other person), | 22 | | ..................... (official title, name, and address), | 23 | | certify that ............., personally known to me to be the | 24 | | same person whose name is subscribed to the foregoing Final and | 25 | | Irrevocable Consent for Adoption by a Specified Person or |
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| 1 | | Persons; non-DCFS case, appeared before me this day in person | 2 | | and acknowledged that (she)(he) signed and delivered the | 3 | | consent as (her)(his) free and voluntary act, for the specified | 4 | | purpose. I am further satisfied that, before signing this | 5 | | Consent, ........ has read, or has had read to him or her, the | 6 | | Birth Parent Rights and Responsibilities-Private Form. | 7 | | A-2. Birth Parent Rights and Responsibilities-Private | 8 | | Form. The Birth Parent Rights and Responsibilities-Private | 9 | | Form must be read by, or have been read to, any person | 10 | | executing a Final and Irrevocable Consent to Adoption under | 11 | | subsection A, a Final and Irrevocable Consent to Adoption by a | 12 | | Specified Person or Persons: Non-DCFS Case under subsection | 13 | | A-1, or a Consent to Adoption of Unborn Child under subsection | 14 | | B prior to the execution of said Consent. The form of the Birth | 15 | | Parent Rights and Responsibilities-Private Form shall be | 16 | | substantially as follows: | 17 | | Birth Parent Rights and Responsibilities-Private Form | 18 | | As a birth parent in the State of Illinois, you have the | 19 | | right: | 20 | | 1. To have your own attorney represent you. The prospective | 21 | | adoptive parents may agree to pay for the cost of your attorney | 22 | | in a manner consistent with Illinois law, but they are not | 23 | | required to do so. | 24 | | 2. To be treated with dignity and respect at all times and | 25 | | to make decisions free from coercion and pressure. | 26 | | 3. To receive counseling before and after signing a Final |
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| 1 | | and Irrevocable Consent to Adoption ("Consent"), a Final and | 2 | | Irrevocable Consent to Adoption by a Specified Person or | 3 | | Persons: Non-DCFS Case ("Specified Consent"), or a Consent to | 4 | | Adoption of Unborn Child ("Unborn Consent"). The prospective | 5 | | adoptive parents may agree to pay for the cost of counseling in | 6 | | a manner consistent with Illinois law, but they are not | 7 | | required to do so. | 8 | | 4. To ask to be involved in choosing your child's | 9 | | prospective adoptive parents and to ask to meet them. | 10 | | 5. To ask your child's prospective adoptive parents any | 11 | | questions that pertain to your decision to place your child | 12 | | with them. | 13 | | 6. To see your child before signing a Consent or Specified | 14 | | Consent. | 15 | | 7. To request contact with your child and/or the child's | 16 | | prospective adoptive parents, with the understanding that any | 17 | | promises regarding contact with your child or receipt of | 18 | | information about the child after signing a Consent, Specified | 19 | | Consent, or Unborn Consent cannot be enforced under Illinois | 20 | | law. | 21 | | 8. To receive copies of all documents that you sign and | 22 | | have those documents provided to you in your preferred | 23 | | language. | 24 | | 9. To request that your identifying information remain | 25 | | confidential, unless required otherwise by Illinois law or | 26 | | court order, and to register with the Illinois Adoption |
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| 1 | | Registry and Medical Information Exchange. | 2 | | 10. To work with an adoption agency or attorney of your | 3 | | choice, or change said agency or attorney, provided you | 4 | | promptly inform all of the parties currently involved. | 5 | | 11. To receive, upon request, a written list of any | 6 | | promised support, financial or otherwise, from your attorney or | 7 | | the attorney for your child's prospective adoptive parents. | 8 | | 12. To delay signing a Consent, Specified Consent, or | 9 | | Unborn Consent if you are not ready to do so. | 10 | | 13. To decline to sign a Consent, Specified Consent, or | 11 | | Unborn Consent even if you have received financial support from | 12 | | the prospective adoptive parents. | 13 | | If you do not receive any of the rights described in this | 14 | | Form, it shall not be a basis to revoke a Consent, Specified | 15 | | Consent, or Unborn Consent. | 16 | | As a Birth Parent in the State of Illinois, you have the | 17 | | responsibility: | 18 | | 1. To carefully consider your reasons for choosing | 19 | | adoption. | 20 | | 2. To voluntarily provide all known medical, background, | 21 | | and family information about yourself and your immediate family | 22 | | to your child's prospective adoptive parents or their attorney. | 23 | | For the health of your child, you are strongly encouraged, but | 24 | | not required, to provide all known medical, background, and | 25 | | family history information about yourself and your family to | 26 | | your child's prospective adoptive parents or their attorney. |
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| 1 | | 3. (Birth mothers only) To accurately complete an Affidavit | 2 | | of Identification, which identifies the father of the child | 3 | | when known, with the understanding that a birth mother has a | 4 | | right to decline to identify the birth father. | 5 | | 4. To not accept financial support or reimbursement of | 6 | | pregnancy related expenses simultaneously from more than one | 7 | | source. | 8 | | B. The form of consent required for the adoption of an | 9 | | unborn child
shall be substantially as follows:
| 10 | | CONSENT TO ADOPTION OF UNBORN CHILD
| 11 | | I, ...., state:
| 12 | | That I am the father of a child expected to be born on or | 13 | | about ....
to .... (name of mother).
| 14 | | That I reside at .... County of ...., and State of .....
| 15 | | That I am of the age of .... years.
| 16 | | That I hereby enter my appearance in such adoption | 17 | | proceeding and
waive service of summons on me.
| 18 | | That I hereby acknowledge that I have been provided with a | 19 | | copy of the Birth Parent Rights and Responsibilities-Private | 20 | | Form before signing this Consent, and that I have had time to | 21 | | read, or have had read to me, this Form. I understand that if I | 22 | | do not receive any of the rights as described in this Form, it | 23 | | shall not constitute a basis to revoke this Consent to Adoption | 24 | | of Unborn Child. | 25 | | That I do hereby consent and agree to the adoption of such | 26 | | child, and
that I have not previously executed a consent or |
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| 1 | | surrender with respect
to such child.
| 2 | | That I wish to and do understand that by signing this | 3 | | consent I do
irrevocably and permanently give up all custody | 4 | | and other parental
rights I have to such child, except that I | 5 | | have the right to revoke this
consent by giving written notice | 6 | | of my revocation not later than 72
hours after the birth of the | 7 | | child.
| 8 | | That I understand such child will be placed for adoption | 9 | | and that,
except as hereinabove provided, I cannot under any | 10 | | circumstances, after
signing this document, change my mind and | 11 | | revoke or cancel this consent
or obtain or recover custody or | 12 | | any other rights over such child.
| 13 | | That I have read and understand the above and I am signing | 14 | | it as my
free and voluntary act.
| 15 | | Dated (insert date).
| 16 | | ........................
| 17 | | B-5. (1) The parent of a child may execute a consent to | 18 | | standby
adoption by a specified person or persons. A consent | 19 | | under this subsection B-5
shall be acknowledged by a parent | 20 | | pursuant to subsection H and subsection K of
this Section.
The | 21 | | form of consent required for the standby adoption of a born | 22 | | child
effective at a future date when the consenting
parent of | 23 | | the child dies or
requests that a final judgment of adoption be | 24 | | entered shall be substantially as
follows:
| 25 | | FINAL AND IRREVOCABLE CONSENT
| 26 | | TO STANDBY ADOPTION
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| 1 | | I, ..., (relationship, e.g. mother or father)
of ...., a | 2 | | ..male child, state:
| 3 | | That the child was born on .... at .....
| 4 | | That I reside at ...., County of ...., and State of .....
| 5 | | That I am of the age of .... years.
| 6 | | That I hereby enter my appearance in this proceeding and | 7 | | waive service of
summons on me in this action only.
| 8 | | That I do hereby consent and
agree to the standby adoption | 9 | | of the child, and that I have not previously
executed a consent | 10 | | or surrender with respect to the child.
| 11 | | That I wish to and understand that by signing this consent | 12 | | I do irrevocably
and permanently give up all custody and other | 13 | | parental rights I have to the
child, effective upon
(my death) | 14 | | (the child's other parent's death) or upon (my) (the other
| 15 | | parent's) request for the entry of a final judgment for | 16 | | adoption if .....
(specified person or persons) adopt my child.
| 17 | | That I understand that until (I die) (the child's other | 18 | | parent dies), I
retain all legal rights and obligations | 19 | | concerning the child, but at that time,
I irrevocably give all | 20 | | custody and other parental rights to .... (specified
person or | 21 | | persons).
| 22 | | I understand my child will be adopted by ....... (specified | 23 | | person or
persons) only and that I cannot, under any | 24 | | circumstances, after signing this
document, change my mind and | 25 | | revoke or cancel this consent or obtain or recover
custody or | 26 | | any other rights over my child if ..... (specified person or
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| 1 | | persons) adopt my child.
| 2 | | I understand that this consent to standby adoption is valid | 3 | | only if the
petition for standby adoption is filed and that if | 4 | | ....... (specified person or
persons), for any reason, cannot | 5 | | or will not file a petition for standby
adoption or if his, | 6 | | her, or their petition for standby adoption is denied, then
| 7 | | this consent is void. I have the right to notice of any other | 8 | | proceeding that
could affect my parental rights.
| 9 | | That I have read and understand the above and I am signing | 10 | | it as my free and
voluntary act.
| 11 | | Dated (insert date).
| 12 | | ....................
| 13 | | If under Section 8 the consent of more than one person is | 14 | | required, then each
such
person shall execute a separate | 15 | | consent. A separate consent shall be executed
for each
child.
| 16 | | (2) If the parent consents to a standby adoption by 2 | 17 | | specified persons,
then the form shall contain 2 additional | 18 | | paragraphs in substantially the
following form:
| 19 | | If .... (specified persons) obtain a judgment of
| 20 | | dissolution of
marriage before the judgment for adoption is | 21 | | entered, then .....
(specified person) shall adopt my child. I | 22 | | understand that I cannot change my
mind and revoke this consent | 23 | | or obtain or recover custody of my child if .....
(specified | 24 | | persons) obtain a judgment of dissolution of marriage and .....
| 25 | | (specified person) adopts my child. I understand that I cannot |
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| 1 | | change my
mind and revoke this consent if ...... (specified | 2 | | persons) obtain a
judgment of dissolution of marriage before | 3 | | the adoption is final. I
understand that this consent to | 4 | | adoption has no effect on who will get custody
of my child if | 5 | | ..... (specified persons) obtain a judgment of dissolution
of | 6 | | marriage after the adoption is final. I understand that if | 7 | | either .....
(specified persons) dies before the petition to | 8 | | adopt my child is granted, then
the surviving person may adopt | 9 | | my child. I understand that I cannot change my
mind and revoke | 10 | | this consent or obtain or recover custody of my child if the
| 11 | | surviving person adopts my child.
| 12 | | A consent to standby adoption by specified persons on this | 13 | | form shall have no
effect on a court's determination of custody | 14 | | or visitation under the Illinois
Marriage and Dissolution
of | 15 | | Marriage Act if the marriage of the specified persons is | 16 | | dissolved before
the adoption is final.
| 17 | | (3) The form of the certificate of acknowledgement for a | 18 | | Final and
Irrevocable Consent for Standby Adoption shall be | 19 | | substantially as follows:
| 20 | | STATE OF .....)
| 21 | | ) SS.
| 22 | | COUNTY OF ....)
| 23 | | I, ....... (name of Judge or other person) ..... (official | 24 | | title,
name, and address), certify that ......., personally |
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| 1 | | known to me to be
the same person whose name is subscribed to | 2 | | the foregoing Final and Irrevocable
Consent to Standby | 3 | | Adoption, appeared before me this day in person and
| 4 | | acknowledged that (she) (he) signed and
delivered the consent | 5 | | as (her) (his) free and voluntary act, for the specified
| 6 | | purpose.
| 7 | | I have fully explained that this consent to adoption is | 8 | | valid only if the
petition to adopt is filed, and that if the | 9 | | specified person or persons, for
any reason, cannot or will not | 10 | | adopt the child or if the adoption petition is
denied, then | 11 | | this consent will be void. I have fully explained that if the
| 12 | | specified person or persons adopt the child, by signing this | 13 | | consent (she) (he)
is irrevocably and permanently | 14 | | relinquishing all parental rights to the child,
and (she) (he) | 15 | | has stated that such is (her) (his) intention and desire.
| 16 | | Dated (insert date).
| 17 | | Signature..............................
| 18 | | (4) If a consent to standby adoption is executed in this | 19 | | form,
the consent shall be valid only if the specified
person | 20 | | or persons adopt the child. The consent shall be void if:
| 21 | | (a) the specified person or persons do not file a petition | 22 | | for standby
adoption of the child; or
| 23 | | (b) a court denies the standby adoption petition.
| 24 | | The parent shall not need to take further action to revoke | 25 | | the consent if the
standby adoption by the specified person or | 26 | | persons does not occur,
notwithstanding the provisions of |
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| 1 | | Section 11 of this Act.
| 2 | | C. The form of surrender to any agency given by a parent of | 3 | | a born
child who is to be subsequently placed for adoption | 4 | | shall be
substantially as follows and shall contain such other | 5 | | facts and
statements as the particular agency shall require.
| 6 | | FINAL AND IRREVOCABLE SURRENDER
| 7 | | FOR PURPOSES OF ADOPTION
| 8 | | I, .... (relationship, e.g., mother, father, relative, | 9 | | guardian) of
...., a ..male child, state:
| 10 | | That such child was born on ...., at .....
| 11 | | That I reside at ...., County of ...., and State of .....
| 12 | | That I am of the age of .... years.
| 13 | | That I do hereby surrender and entrust the entire custody | 14 | | and control
of such child to the .... (the "Agency"), a | 15 | | (public) (licensed) child
welfare agency with its principal | 16 | | office in the City of ...., County of
.... and State of ...., | 17 | | for the purpose of enabling it to care for and
supervise the | 18 | | care of such child, to place such child for adoption and
to | 19 | | consent to the legal adoption of such child.
| 20 | | That I hereby grant to the Agency full power and authority | 21 | | to place
such child with any person or persons it may in its | 22 | | sole discretion
select to become the adopting parent or parents | 23 | | and to consent to the
legal adoption of such child by such | 24 | | person or persons; and to take any
and all measures which, in | 25 | | the judgment of the Agency, may be for the
best interests of | 26 | | such child, including authorizing medical, surgical
and dental |
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| 1 | | care and treatment including inoculation and anaesthesia for
| 2 | | such child.
| 3 | | That I wish to and understand that by signing this | 4 | | surrender I do
irrevocably and permanently give up all custody | 5 | | and other parental
rights I have to such child.
| 6 | | That I understand I cannot under any circumstances, after | 7 | | signing
this surrender, change my mind and revoke or cancel | 8 | | this surrender or
obtain or recover custody or any other rights | 9 | | over such child.
| 10 | | That I have read and understand the above and I am signing | 11 | | it as my
free and voluntary act.
| 12 | | Dated (insert date).
| 13 | | ........................
| 14 | | C-5. The form of a Final and Irrevocable Designated | 15 | | Surrender for Purposes of Adoption to any agency given by a | 16 | | parent of a born child who is to be subsequently placed for | 17 | | adoption is to be used by legal parents only. The form shall be | 18 | | substantially as follows and shall contain such other facts and | 19 | | statements as the particular agency shall require: | 20 | | FINAL AND IRREVOCABLE DESIGNATED SURRENDER | 21 | | FOR PURPOSES OF ADOPTION | 22 | | I, .... (relationship, e.g., mother, father, relative, | 23 | | guardian) of ...., a ..male child, state: | 24 | | 1. That such child was born on ...., at ..... | 25 | | 2. That I reside at ...., County of ...., and State of | 26 | | ..... |
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| 1 | | 3. That I am of the age of .... years. | 2 | | 4. That I do hereby surrender and entrust the entire | 3 | | custody and control of such child to the .... (the "Agency"), a | 4 | | (public) (licensed) child welfare agency with its principal | 5 | | office in the City of ...., County of .... and State of ...., | 6 | | for the purpose of enabling it to care for and supervise the | 7 | | care of such child, to place such child for adoption with | 8 | | ............................. (specified person or persons) | 9 | | and to consent to the legal adoption of such child and to take | 10 | | any and all measures which, in the judgment of the Agency, may | 11 | | be for the best interests of such child, including authorizing | 12 | | medical, surgical and dental care and treatment including | 13 | | inoculation and anesthesia for such child. | 14 | | 5. That I wish to and understand that by signing this | 15 | | surrender I do irrevocably and permanently give up all custody | 16 | | and other parental rights I have to such child. | 17 | | 6. That if the petition for adoption is not filed by the
| 18 | | specified person or persons designated herein or, if the
| 19 | | petition for adoption is filed but the adoption petition is
| 20 | | dismissed with prejudice or the adoption proceeding is
| 21 | | otherwise concluded without an order declaring the child to be
| 22 | | the adopted child of each specified person, then I understand | 23 | | that the Agency will provide notice to me within 10 business | 24 | | days and that such notice will be directed to me using the | 25 | | contact information I have provided to the Agency. I understand | 26 | | that I will have 10 business days from the date that the Agency |
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| 1 | | sends me its notice to respond, within which time I may choose | 2 | | to designate other adoptive parent(s). However, I acknowledge | 3 | | that
the Agency has full power and authority to place the child | 4 | | for adoption with
any person or persons it may in its sole | 5 | | discretion select to
become the adopting parent or parents and | 6 | | to consent to the
legal adoption of the child by such person or | 7 | | persons. | 8 | | 7. That I acknowledge that this surrender is valid even if | 9 | | the specified persons separate or divorce or one of the | 10 | | specified persons dies prior to the entry of the final judgment | 11 | | for adoption. | 12 | | 8. That I expressly acknowledge that the above paragraphs 6 | 13 | | and 7 do not impair the validity and absolute finality of this | 14 | | surrender under any circumstance. | 15 | | 9. That I understand that I have a remaining obligation to | 16 | | keep the Agency informed of my current contact information | 17 | | until the adoption of the child has been finalized if I wish to | 18 | | be notified in the event the adoption by the specified | 19 | | person(s) cannot proceed. | 20 | | 10. That I understand I cannot under any circumstances, | 21 | | after signing this surrender, change my mind and revoke or | 22 | | cancel this surrender or obtain or recover custody or any other | 23 | | rights over such child. | 24 | | 11. That I have read and understand the above and I am | 25 | | signing it as my free and voluntary act. | 26 | | Dated (insert date). |
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| 1 | | .............................. | 2 | | D. The form of surrender to an agency given by a parent of | 3 | | an unborn
child who is to be subsequently placed for adoption | 4 | | shall be
substantially as follows and shall contain such other | 5 | | facts and
statements as the particular agency shall require.
| 6 | | SURRENDER OF UNBORN CHILD FOR
| 7 | | PURPOSES OF ADOPTION
| 8 | | I, .... (father), state:
| 9 | | That I am the father of a child expected to be born on or | 10 | | about ....
to .... (name of mother).
| 11 | | That I reside at ...., County of ...., and State of .....
| 12 | | That I am of the age of .... years.
| 13 | | That I do hereby surrender and entrust the entire custody | 14 | | and control
of such child to the .... (the "Agency"), a | 15 | | (public) (licensed) child
welfare agency with its principal | 16 | | office in the City of ...., County of
.... and State of ...., | 17 | | for the purpose of enabling it to care for and
supervise the | 18 | | care of such child, to place such child for adoption and
to | 19 | | consent to the legal adoption of such child, and that I have | 20 | | not
previously executed a consent or surrender with respect to | 21 | | such child.
| 22 | | That I hereby grant to the Agency full power and authority | 23 | | to place
such child with any person or persons it may in its | 24 | | sole discretion
select to become the adopting parent or parents | 25 | | and to consent to the
legal adoption of such child by such | 26 | | person or persons; and to take any
and all measures which, in |
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| 1 | | the judgment of the Agency, may be for the
best interests of | 2 | | such child, including authorizing medical, surgical
and dental | 3 | | care and treatment, including inoculation and anaesthesia for
| 4 | | such child.
| 5 | | That I wish to and understand that by signing this | 6 | | surrender I do
irrevocably and permanently give up all custody | 7 | | and other parental
rights I have to such child.
| 8 | | That I understand I cannot under any circumstances, after | 9 | | signing
this surrender, change my mind and revoke or cancel | 10 | | this surrender or
obtain or recover custody or any other rights | 11 | | over such child, except
that I have the right to revoke this | 12 | | surrender by giving written notice
of my revocation not later | 13 | | than 72 hours after the birth of such child.
| 14 | | That I have read and understand the above and I am signing | 15 | | it as my
free and voluntary act.
| 16 | | Dated (insert date).
| 17 | | ........................
| 18 | | E. The form of consent required from the parents for the | 19 | | adoption of
an adult, when such adult elects to obtain such | 20 | | consent, shall be
substantially as follows:
| 21 | | CONSENT
| 22 | | I, ...., (father) (mother) of ...., an adult, state:
| 23 | | That I reside at ...., County of .... and State of .....
| 24 | | That I do hereby consent and agree to the adoption of such | 25 | | adult by
.... and .....
| 26 | | Dated (insert date).
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| 1 | | .........................
| 2 | | F. The form of consent required for the adoption of a child | 3 | | of the
age of 14 years or upwards, or of an adult, to be given | 4 | | by such person,
shall be substantially as follows:
| 5 | | CONSENT
| 6 | | I, ...., state:
| 7 | | That I reside at ...., County of .... and State of ..... | 8 | | That I am
of the age of .... years. That I consent and agree to | 9 | | my adoption by
.... and .....
| 10 | | Dated (insert date).
| 11 | | ........................
| 12 | | G. The form of consent given by an agency to the adoption | 13 | | by
specified persons of a child previously surrendered to it | 14 | | shall set
forth that the agency has the authority to execute | 15 | | such consent. The
form of consent given by a guardian of the | 16 | | person of a child sought to
be adopted, appointed by a court of | 17 | | competent jurisdiction, shall set
forth the facts of such | 18 | | appointment and the authority of the guardian to
execute such | 19 | | consent.
| 20 | | H. A consent (other than that given by an agency, or | 21 | | guardian of the
person of the child sought to be adopted who | 22 | | was appointed by a court of
competent jurisdiction) shall be | 23 | | acknowledged by a parent before a judge of a court of competent | 24 | | jurisdiction or, except as otherwise provided in
this Act, | 25 | | before a representative of an agency, or before a person, other | 26 | | than the attorney for the prospective adoptive parent or |
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| 1 | | parents, designated by a court of competent
jurisdiction.
| 2 | | I. A surrender, or any other document equivalent to a | 3 | | surrender, by
which a child is surrendered to an agency shall | 4 | | be acknowledged by the
person signing such surrender, or other | 5 | | document, before a judge of a court of competent jurisdiction, | 6 | | or, except as otherwise provided in this Act, before a | 7 | | representative of an agency, or before a person designated by a | 8 | | court
of competent jurisdiction.
| 9 | | J. The form of the certificate of acknowledgment for a | 10 | | consent, a
surrender, or any other document equivalent to a | 11 | | surrender, shall be
substantially as follows:
| 12 | | STATE OF ....)
| 13 | | ) SS.
| 14 | | COUNTY OF ...)
| 15 | | I, .... (Name of judge or other person), .... (official | 16 | | title, name and
location of court or status or position of | 17 | | other person),
certify that ...., personally known to me to be | 18 | | the same person whose
name is subscribed to the foregoing | 19 | | (consent) (surrender), appeared
before me this day in person | 20 | | and acknowledged that (she) (he) signed and
delivered such | 21 | | (consent) (surrender) as (her) (his) free and voluntary
act, | 22 | | for the specified purpose.
| 23 | | I have fully explained that by signing such (consent) | 24 | | (surrender)
(she) (he) is irrevocably relinquishing all | 25 | | parental rights to such
child or adult and (she) (he) has | 26 | | stated that such is (her) (his)
intention and desire. (Add if |
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| 1 | | Consent only) I am further satisfied that, before signing this | 2 | | Consent, ........ has read, or has had read to him or her, the | 3 | | Birth Parent Rights and Responsibilities-Private Form.
| 4 | | Dated (insert date).
| 5 | | Signature ...............
| 6 | | K. When the execution of a consent or a surrender is | 7 | | acknowledged
before someone other than a judge,
such other | 8 | | person shall have his or her signature on the certificate
| 9 | | acknowledged before a notary public, in form substantially as | 10 | | follows:
| 11 | | STATE OF ....)
| 12 | | ) SS.
| 13 | | COUNTY OF ...)
| 14 | | I, a Notary Public, in and for the County of ......, in the | 15 | | State of
......, certify that ...., personally known to me to | 16 | | be the
same person whose name is subscribed to the foregoing | 17 | | certificate of
acknowledgment, appeared before me in person and | 18 | | acknowledged that (she)
(he) signed such certificate as (her) | 19 | | (his) free and voluntary act and
that the statements made in | 20 | | the certificate are true.
| 21 | | Dated (insert date).
| 22 | | Signature ...................... Notary Public
| 23 | | (official seal)
| 24 | | There shall be attached a certificate of magistracy, or | 25 | | other
comparable proof of office of the notary public |
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| 1 | | satisfactory to the
court, to a consent signed and acknowledged | 2 | | in another state.
| 3 | | L. A surrender or consent executed and acknowledged outside | 4 | | of this
State, either in accordance with the law of this State | 5 | | or in accordance
with the law of the place where executed, is | 6 | | valid.
| 7 | | M. Where a consent or a surrender is signed in a foreign | 8 | | country,
the execution of such consent shall be acknowledged or | 9 | | affirmed in a
manner conformable to the law and procedure of | 10 | | such country.
| 11 | | N. If the person signing a consent or surrender is in the | 12 | | military
service of the United States, the execution of such | 13 | | consent or surrender
may be acknowledged before a commissioned | 14 | | officer and the signature of
such officer on such certificate | 15 | | shall be verified or acknowledged
before a notary public or by | 16 | | such other procedure as is then in effect
for such division or | 17 | | branch of the armed forces.
| 18 | | O. (1) The parent or parents of a child in whose interests | 19 | | a petition
under Section 2-13 of the Juvenile Court Act of 1987 | 20 | | is pending may, with the
approval of the designated | 21 | | representative of the Department of Children and
Family | 22 | | Services, execute a consent to adoption by a specified person | 23 | | or
persons:
| 24 | | (a) in whose physical custody the child has resided for | 25 | | at least 6
months;
or
| 26 | | (b) in whose physical custody at least one sibling of |
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| 1 | | the child who is the
subject of this consent has resided | 2 | | for at least 6 months, and
the child who is
the subject of | 3 | | this consent is currently residing in this foster home; or
| 4 | | (c) in whose physical custody a child under one year of | 5 | | age has resided
for at least 3 months.
| 6 | | A consent under this subsection O shall be acknowledged by a | 7 | | parent pursuant to
subsection H and subsection K of this | 8 | | Section.
| 9 | | (2) The consent to adoption by a specified person or | 10 | | persons shall have the
caption of the proceeding in which it is | 11 | | to be filed and shall be substantially
as follows:
| 12 | | FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY
| 13 | | A SPECIFIED PERSON OR PERSONS: DCFS CASE
| 14 | | I, ......................................, the | 15 | | .................. (mother or
father) of a ....male child, | 16 | | state:
| 17 | | My child ............................ (name of child) | 18 | | was born on
(insert date) at .................... Hospital | 19 | | in
................ County, State of ...............
| 20 | | I reside at ......................, County of | 21 | | ............. and
State of ..............
| 22 | | I, ..........................., am .... years old.
| 23 | | I enter my appearance in this action to adopt my child | 24 | | by the
person or persons specified herein by me and waive | 25 | | service of
summons on me in this action only.
| 26 | | I consent to the adoption of my child by
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| 1 | | .............................
(specified person or | 2 | | persons) only.
| 3 | | I wish to sign this consent and I understand that by | 4 | | signing this
consent I irrevocably and permanently give up | 5 | | all parental rights I have to my
child if my child is | 6 | | adopted by ............................. (specified person
| 7 | | or persons).
| 8 | | I understand my child will be adopted by | 9 | | .............................
(specified person or | 10 | | persons) only and that I cannot under any circumstances,
| 11 | | after signing this document, change my mind and revoke or | 12 | | cancel this consent
or obtain or recover custody or any | 13 | | other rights over my child if
............................ | 14 | | (specified person or persons) adopt my child.
| 15 | | I understand that this consent to adoption is valid | 16 | | only if the
petition to adopt is filed within one year from | 17 | | the date that I sign it and
that if ....................... | 18 | | (specified person or persons), for any reason,
cannot or | 19 | | will not file a petition to adopt my child within that one | 20 | | year
period or if their adoption petition is denied, then | 21 | | this consent will be
voidable after one year upon the | 22 | | timely filing of my motion. If I file this
motion before | 23 | | the filing of the petition for adoption, I understand that | 24 | | the
court shall revoke this specific consent.
I have the | 25 | | right to notice of any other proceeding that could affect | 26 | | my
parental rights, except for the proceeding for |
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| 1 | | ............. (specified person
or persons) to adopt my | 2 | | child.
| 3 | | I have read and understand the above and I am signing | 4 | | it as my free
and voluntary act.
| 5 | | Dated (insert date).
| 6 | | .............................................
| 7 | | Signature of parent
| 8 | | (3) If the parent consents to an adoption by 2 specified | 9 | | persons, then the
form shall contain 2 additional paragraphs in | 10 | | substantially the following form:
| 11 | | If ............... (specified persons) get a divorce
| 12 | | before the petition to adopt my child is granted, then | 13 | | ..........
(specified person) shall adopt my child. I | 14 | | understand that I
cannot change my mind and revoke this | 15 | | consent or obtain or
recover custody over my child if | 16 | | ............. (specified persons)
divorce and | 17 | | ............. (specified person) adopts my
child. I | 18 | | understand that I cannot change my mind and revoke
this | 19 | | consent or obtain or recover custody over my child if
| 20 | | ................. (specified persons) divorce after the
| 21 | | adoption is final. I understand that this consent to | 22 | | adoption
has no effect on who will get custody of my child | 23 | | if they
divorce after the adoption is final.
| 24 | | I understand that if either ...............
| 25 | | (specified persons) dies before the petition to adopt
my | 26 | | child is granted, then the surviving person can adopt my |
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| 1 | | child. I
understand that I cannot change my mind and revoke | 2 | | this consent
or obtain or recover custody over my child if | 3 | | the surviving
person adopts my child.
| 4 | | A consent to adoption by specified persons on this form | 5 | | shall
have no effect on a court's determination of custody or | 6 | | visitation
under the Illinois Marriage and Dissolution of | 7 | | Marriage Act if the
marriage of the
specified persons is | 8 | | dissolved after the adoption is final.
| 9 | | (4) The form of the certificate of acknowledgement for a | 10 | | Final and
Irrevocable Consent for Adoption by a Specified | 11 | | Person or Persons: DCFS Case shall be
substantially as follows:
| 12 | | STATE OF..............)
| 13 | | ) SS.
| 14 | | COUNTY OF.............)
| 15 | | I, .................... (Name of Judge or other person),
| 16 | | ..................... (official title, name, and address),
| 17 | | certify that ............., personally known to me to be the | 18 | | same person whose
name is subscribed to the foregoing Final and | 19 | | Irrevocable Consent for Adoption
by a Specified Person or | 20 | | Persons, appeared before me this day
in person and acknowledged | 21 | | that (she)(he) signed and delivered the consent as
(her)(his) | 22 | | free and voluntary act, for the specified purpose.
| 23 | | I have fully explained that this consent to adoption is | 24 | | valid only if the
petition to adopt is filed within one year |
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| 1 | | from the date that it is signed, and
that if the specified | 2 | | person or persons, for any reason, cannot or will not
adopt the | 3 | | child or if the adoption petition is denied, then this consent | 4 | | will
be voidable after one year upon the timely filing of a | 5 | | motion by the parent
to revoke the consent. I explained that if | 6 | | this motion is filed before the
filing of the petition for | 7 | | adoption, the court shall revoke this specific
consent. I have | 8 | | fully explained that if the specified person or
persons adopt
| 9 | | the child, by signing this consent this parent is irrevocably
| 10 | | and permanently
relinquishing all parental rights to the child, | 11 | | and this parent has stated that
such is (her)(his) intention | 12 | | and desire.
| 13 | | Dated (insert date).
| 14 | | ...............................
| 15 | | Signature
| 16 | | (5) If a consent to adoption by a specified person or | 17 | | persons is executed in
this form, the following provisions | 18 | | shall apply. The consent shall be valid
only if that specified | 19 | | person or persons adopt the child. The consent shall be
| 20 | | voidable after one year if:
| 21 | | (a) the specified person or persons do not file a | 22 | | petition to adopt the
child within one year after the | 23 | | consent is signed and the parent files a
timely motion to | 24 | | revoke this consent. If this motion is filed before the
| 25 | | filing of the petition for adoption the court shall revoke | 26 | | this consent; or
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| 1 | | (b) a court denies the adoption petition; or
| 2 | | (c) the Department of Children and Family Services | 3 | | Guardianship
Administrator determines that the specified | 4 | | person or persons will not or
cannot complete the adoption, | 5 | | or in the best interests of the child should not
adopt the | 6 | | child.
| 7 | | Within 30 days of the consent becoming void, the Department | 8 | | of Children and
Family Services Guardianship Administrator | 9 | | shall make good faith attempts to
notify the parent in writing | 10 | | and shall give written notice to the court and all
additional | 11 | | parties in writing that the adoption has not occurred or will | 12 | | not
occur and that the consent is void. If the adoption by a | 13 | | specified person or
persons does not occur, no proceeding for | 14 | | termination of parental rights shall
be brought unless the | 15 | | biological parent who executed the consent to adoption by
a | 16 | | specified person or persons has been notified of the proceeding | 17 | | pursuant to
Section 7 of this Act or subsection (4) of Section | 18 | | 2-13 of the Juvenile Court
Act of 1987. The parent shall not | 19 | | need to take further action to revoke the
consent if the | 20 | | specified adoption does not occur, notwithstanding the
| 21 | | provisions of Section 11 of this Act.
| 22 | | (6) The Department of Children and Family Services is | 23 | | authorized
to promulgate rules necessary to implement this | 24 | | subsection O.
| 25 | | (7) The Department shall collect and maintain data | 26 | | concerning the efficacy
of specific consents. This data shall |
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| 1 | | include the number of specific consents
executed and their | 2 | | outcomes, including but not limited to the number of
children | 3 | | adopted pursuant to the consents, the number of children for | 4 | | whom
adoptions are not completed, and the reason or reasons why | 5 | | the adoptions are
not completed.
| 6 | | P. If the person signing a consent is incarcerated or | 7 | | detained in a correctional facility, prison, jail, detention | 8 | | center, or other comparable institution, either in this State | 9 | | or any other jurisdiction, the execution of such consent may be | 10 | | acknowledged before social service personnel of such | 11 | | institution, or before a person designated by a court of | 12 | | competent jurisdiction. | 13 | | Q. A consent may be acknowledged telephonically, via | 14 | | audiovisual connection, or other electronic means, provided | 15 | | that a court of competent jurisdiction has entered an order | 16 | | approving the execution of the consent in such manner and has | 17 | | designated an individual to be physically present with the | 18 | | parent executing such consent in order to verify the identity | 19 | | of the parent. | 20 | | R. An agency whose representative is acknowledging a | 21 | | consent pursuant to this Section shall be a public child | 22 | | welfare agency, or a child welfare agency, or a child placing | 23 | | agency that is authorized or licensed in the State or | 24 | | jurisdiction in which the consent is signed. | 25 | | (Source: P.A. 96-601, eff. 8-21-09; 96-1461, eff. 1-1-11.)
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