Full Text of HB3967 99th General Assembly
HB3967 99TH GENERAL ASSEMBLY |
| | 99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016 HB3967 Introduced , by Rep. Joe Sosnowski SYNOPSIS AS INTRODUCED: |
| 750 ILCS 50/18.06 | | 750 ILCS 50/18.1 | from Ch. 40, par. 1522.1 | 750 ILCS 50/18.2 | from Ch. 40, par. 1522.2 | 750 ILCS 50/18.3a | from Ch. 40, par. 1522.3a |
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Amends the Adoption Act. Defines "birth grandparent" as the biological parent of a non-surrendered person who is a deceased birth parent. Provides that a birth grandparent who has submitted birth certificates for himself or herself and for a deceased birth parent as well as proof of death for the deceased birth parent may file a Registration Identification Form and an Information Exchange Authorization or a Denial of Information Exchange if the birth parent did not file documentation preventing the exchange of information prior to his or her death. Makes corresponding changes.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | 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 Sections | 5 | | 18.06, 18.1, 18.2, and 18.3a as follows:
| 6 | | (750 ILCS 50/18.06)
| 7 | | Sec. 18.06. Definitions. When used in Sections
18.05 | 8 | | through Section 18.6, for the purposes of the Registry:
| 9 | | "Adopted person" means a person who was adopted
pursuant to | 10 | | the laws in effect at the time of the adoption.
| 11 | | "Adoptive parent" means a person who has become a parent | 12 | | through the legal
process of adoption.
| 13 | | "Adult child" means the biological child 21 years of age or | 14 | | over of a deceased adopted or surrendered person.
| 15 | | "Adult grandchild" means the biological grandchild 21 | 16 | | years of age or over of a deceased adopted or surrendered | 17 | | person. | 18 | | "Adult adopted or surrendered person" means an adopted or | 19 | | surrendered person 21 years of age or over. | 20 | | "Agency" means a public child welfare agency or a licensed | 21 | | child welfare
agency.
| 22 | | "Birth aunt" means the adult full or half sister of a | 23 | | deceased birth parent.
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| 1 | | "Birth father" means the biological father of an adopted or | 2 | | surrendered
person who is named on the original certificate of | 3 | | live birth or on a consent
or surrender document, or a | 4 | | biological father whose paternity has been
established by a | 5 | | judgment or order of the court, pursuant to the Illinois
| 6 | | Parentage Act of 1984.
| 7 | | "Birth grandparent" means the biological parent of: (i) a | 8 | | non-surrendered person who is a deceased birth mother; or (ii) | 9 | | a non-surrendered person who is a deceased birth father. | 10 | | "Birth mother" means the biological mother of an adopted or | 11 | | surrendered
person.
| 12 | | "Birth parent" means a birth mother or birth father of an | 13 | | adopted or
surrendered person.
| 14 | | "Birth Parent Preference Form" means the form prepared by | 15 | | the Department of Public Health pursuant to Section 18.2 | 16 | | completed by a birth parent registrant and filed with the | 17 | | Registry that indicates the birth parent's preferences | 18 | | regarding contact and, if applicable, the release of his or her | 19 | | identifying information on the non-certified copy of the | 20 | | original birth certificate released to an adult adopted or | 21 | | surrendered person or to the surviving adult child or surviving | 22 | | spouse of a deceased adopted or surrendered person who has | 23 | | filed a Request for a Non-Certified Copy of an Original Birth | 24 | | Certificate. | 25 | | "Birth relative" means a birth mother, birth father, birth | 26 | | grandparent, birth sibling, birth aunt, or birth uncle.
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| 1 | | "Birth sibling" means the adult full or half sibling
of an | 2 | | adopted or
surrendered person.
| 3 | | "Birth uncle" means the adult full or half brother of a | 4 | | deceased birth parent.
| 5 | | "Confidential intermediary" means an individual certified | 6 | | by the Department of Children and Family Services pursuant to | 7 | | Section 18.3a(e). | 8 | | "Denial of Information Exchange" means an affidavit | 9 | | completed by a
registrant with the Illinois Adoption Registry | 10 | | and Medical Information Exchange
denying the release of | 11 | | identifying information which has been filed with the Registry.
| 12 | | "Information Exchange Authorization" means
an affidavit | 13 | | completed by a registrant with the Illinois Adoption Registry | 14 | | and
Medical Information Exchange authorizing the release of | 15 | | identifying
information which has been filed with the Registry.
| 16 | | "Medical Information Exchange Questionnaire" means the | 17 | | medical
history
questionnaire completed by a registrant of the | 18 | | Illinois Adoption Registry and
Medical Information Exchange.
| 19 | | "Non-certified Copy of the Original Birth Certificate" | 20 | | means a non-certified copy of the original certificate of live | 21 | | birth of an adult adopted or surrendered person who was born in | 22 | | Illinois. | 23 | | "Proof of death" means a death certificate.
| 24 | | "Registrant" or "Registered Party" means a birth parent, | 25 | | birth grandparent, birth sibling,
birth aunt, birth uncle, | 26 | | adopted or surrendered person 21 years of age or over, adoptive |
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| 1 | | parent or legal
guardian of an adopted or surrendered person | 2 | | under the age of 21, or adoptive parent, surviving spouse, or | 3 | | adult child of a deceased adopted or surrendered person who has | 4 | | filed
an Illinois Adoption Registry Application or | 5 | | Registration Identification Form
with the Registry.
| 6 | | "Registry" means the Illinois Adoption Registry and | 7 | | Medical Information Exchange. | 8 | | "Request for a Non-Certified Copy of an Original Birth | 9 | | Certificate" means an affidavit completed by an adult adopted | 10 | | or surrendered person or by the surviving adult child or | 11 | | surviving spouse of a deceased adopted or surrendered person | 12 | | and filed with the Registry requesting a non-certified copy of | 13 | | an adult adopted or surrendered person's original certificate | 14 | | of live birth in Illinois. | 15 | | "Surrendered person" means a person whose parents' rights | 16 | | have been
surrendered or terminated but who has not been | 17 | | adopted.
| 18 | | "Surviving spouse" means the wife or husband, 21 years of | 19 | | age or older, of a deceased adopted or surrendered person who | 20 | | would be 21 years of age or older if still alive and who has one | 21 | | or more surviving biological children who are under the age of | 22 | | 21.
| 23 | | "18.3 statement" means a statement regarding the | 24 | | disclosure of identifying information signed by a birth parent | 25 | | under Section 18.3 of this Act as it existed immediately prior | 26 | | to the effective date of this amendatory Act of the 96th |
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| 1 | | General Assembly. | 2 | | (Source: P.A. 97-110, eff. 7-14-11; 98-704, eff. 1-1-15 .)
| 3 | | (750 ILCS 50/18.1) (from Ch. 40, par. 1522.1)
| 4 | | Sec. 18.1. Disclosure of identifying information.
| 5 | | (a) The Department of Public Health shall establish and | 6 | | maintain a
Registry for the purpose of allowing mutually
| 7 | | consenting members of birth and adoptive families to exchange | 8 | | identifying and medical information. Identifying information | 9 | | for
the purpose of this Act shall mean any one or more of the | 10 | | following:
| 11 | | (1) The name and last known address of the consenting | 12 | | person or persons.
| 13 | | (2) A copy of the Illinois Adoption Registry | 14 | | Application of the
consenting person or persons.
| 15 | | (3) A non-certified copy of the original birth | 16 | | certificate of an adult adopted
or surrendered person.
| 17 | | (b) Written authorization from all parties identified must | 18 | | be received prior
to disclosure of any identifying information, | 19 | | with the exception of non-certified copies of original birth | 20 | | certificates released to adult adopted or surrendered persons | 21 | | or to surviving adult children and surviving spouses of | 22 | | deceased adopted or surrendered persons pursuant to the | 23 | | procedures outlined in Section 18.1b(e).
| 24 | | (c) At any time after a child is surrendered for adoption, | 25 | | or at any
time during the adoption proceedings or at any time |
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| 1 | | thereafter, either
birth parent or both of them may file with | 2 | | the Registry a Birth
Parent Registration Identification Form.
| 3 | | (d) A birth sibling 21 years of age or over who was not | 4 | | surrendered for
adoption and who has submitted a copy of his or | 5 | | her birth certificate as well as proof of death for a deceased | 6 | | birth parent
and such birth parent did not file a Denial of | 7 | | Information Exchange or a Birth Parent Preference Form on which | 8 | | Option E was selected with the
Registry prior to his or her | 9 | | death may file a Registration Identification Form
and an | 10 | | Information Exchange Authorization or a Denial of Information | 11 | | Exchange.
| 12 | | (e) A birth aunt or birth uncle who has submitted birth | 13 | | certificates for himself or herself and for a deceased birth | 14 | | parent naming at least one common biological parent as well as | 15 | | proof of death for the deceased birth parent and such birth | 16 | | parent did not file a Denial of Information Exchange or a Birth | 17 | | Parent Preference Form on which Option E was selected with the | 18 | | Registry prior to his or her death may file a Registration | 19 | | Identification Form and an Information Exchange Authorization | 20 | | or a Denial of Information Exchange. | 21 | | (e-5) A birth grandparent who has submitted birth | 22 | | certificates for himself or herself and for a deceased birth | 23 | | parent as well as proof of death for the deceased birth parent | 24 | | and the birth parent did not file a Denial of Information | 25 | | Exchange or a Birth Parent Preference Form on which Option E | 26 | | was selected with the Registry prior to his or her death may |
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| 1 | | file a Registration Identification Form and an Information | 2 | | Exchange Authorization or a Denial of Information Exchange. | 3 | | (f) Any adopted person 21 years of age or over, any | 4 | | surrendered person
21 years of age or over, or any adoptive | 5 | | parent or legal guardian of an
adopted or surrendered person | 6 | | under the age of 21 may file with the Registry
a Registration | 7 | | Identification Form and an Information Exchange Authorization
| 8 | | or a Denial of Information Exchange.
| 9 | | (g) Any adult child or adult grandchild 21 years of age or | 10 | | over of a deceased adopted or surrendered person who has | 11 | | submitted a copy of his or her birth certificate naming an | 12 | | adopted or surrendered person as his or her biological parent | 13 | | as well as proof of death for the deceased adopted or | 14 | | surrendered person and such adopted or surrendered person did | 15 | | not file a Denial of Information Exchange with the Registry | 16 | | prior to his or her death may file a Registration | 17 | | Identification Form and an Information Exchange Authorization | 18 | | or a Denial of Information Exchange.
| 19 | | (h) Any surviving spouse of a deceased adopted or | 20 | | surrendered person 21 years of age or over who has submitted | 21 | | proof of death for the deceased adopted or surrendered person | 22 | | and such adopted or surrendered person did not file a Denial of | 23 | | Information Exchange with the Registry prior to his or her | 24 | | death as well as a birth certificate naming themselves and the | 25 | | adopted or surrendered person as the parents of a minor child | 26 | | under the age of 21 may file a Registration Identification Form |
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| 1 | | and an Information Exchange Authorization or a Denial of | 2 | | Information Exchange.
| 3 | | (i) Any adoptive parent or legal guardian of a deceased | 4 | | adopted or surrendered person who is 21 years of age or over | 5 | | who has submitted proof of death as well as proof of parentage | 6 | | or guardianship for the deceased adopted or surrendered person | 7 | | and such adopted or surrendered person did not file a Denial of | 8 | | Information Exchange with the Registry prior to his or her | 9 | | death may file a Registration Identification Form and an | 10 | | Information Exchange Authorization or a Denial of Information | 11 | | Exchange.
| 12 | | (j) The Department of Public Health shall supply to the | 13 | | adopted or
surrendered person or his or her adoptive parents, | 14 | | legal guardians, adult children, adult grandchildren, or | 15 | | surviving spouse, and
to the birth parents identifying | 16 | | information only if both the adopted or
surrendered person, or | 17 | | one of his or her adoptive parents, legal guardians, adult | 18 | | children, adult grandchildren, or his or her surviving spouse, | 19 | | and
the birth parents have filed with the Registry an | 20 | | Information Exchange
Authorization or a Birth Parent | 21 | | Preference Form on which Option A, B, or C was selected and the | 22 | | information at the Registry indicates that the
consenting | 23 | | adopted or surrendered person, the child of the consenting
| 24 | | adoptive parents or legal guardians, the parent of the | 25 | | consenting adult child of the adopted or surrendered person, or | 26 | | the deceased wife or husband of the consenting surviving spouse
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| 1 | | is the child of the consenting birth
parents, except | 2 | | identifying information that appears on a non-certified copy of | 3 | | an original birth certificate may be provided to an adult | 4 | | adopted or surrendered person or to the surviving adult child, | 5 | | adult grandchild, or surviving spouse of a deceased adopted or | 6 | | surrendered person pursuant to the procedures outlined in | 7 | | Section 18.1b(e) of this Act.
| 8 | | The Department of Public Health shall supply to adopted or | 9 | | surrendered
persons who are birth siblings identifying | 10 | | information only if both siblings
have filed with the Registry | 11 | | an Information Exchange Authorization and the
information at | 12 | | the Registry indicates that the consenting siblings have one
or | 13 | | both birth parents in common. Identifying information shall be | 14 | | supplied to
consenting birth siblings who were adopted or | 15 | | surrendered if any such sibling
is 21 years of age or over. | 16 | | Identifying information shall be supplied to
consenting birth | 17 | | siblings who were not adopted or surrendered if any such
| 18 | | sibling is 21 years of age or over and has proof of death of the | 19 | | common birth
parent and such birth parent did not file a Denial | 20 | | of Information Exchange or a Birth Parent Preference Form on | 21 | | which Option E was selected
with the Registry prior to his or | 22 | | her death.
| 23 | | (k) The Department of Public Health shall supply to the | 24 | | adopted or surrendered person or his or her adoptive parents, | 25 | | legal guardians, adult children, adult grandchildren, or | 26 | | surviving spouse, and to a birth aunt identifying information |
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| 1 | | only if both the adopted or surrendered person or one of his or | 2 | | her adoptive parents, legal guardians, adult children, adult | 3 | | grandchildren, or his or her surviving spouse, and the birth | 4 | | aunt have filed with the Registry an Information Exchange | 5 | | Authorization and the information at the Registry indicates | 6 | | that the consenting adopted or surrendered person, or the child | 7 | | of the consenting adoptive parents or legal guardians, or the | 8 | | parent of the consenting adult child, or the deceased wife or | 9 | | husband of the consenting surviving spouse of the adopted or | 10 | | surrendered person is or was the child of the brother or sister | 11 | | of the consenting birth aunt.
| 12 | | (l) The Department of Public Health shall supply to the | 13 | | adopted or surrendered person or his or her adoptive parents, | 14 | | legal guardians, adult children, adult grandchildren, or | 15 | | surviving spouse, and to a birth uncle identifying information | 16 | | only if both the adopted or surrendered person or one of his or | 17 | | her adoptive parents, legal guardians, adult children, adult | 18 | | grandchildren, or his or her surviving spouse, and the birth | 19 | | uncle have filed with the Registry an Information Exchange | 20 | | Authorization and the information at the Registry indicates | 21 | | that the consenting adopted or surrendered person, or the child | 22 | | of the consenting adoptive parents or legal guardians, or the | 23 | | parent of the consenting adult child, or the deceased wife or | 24 | | husband of the consenting surviving spouse of the adopted or | 25 | | surrendered person is or was the child of the brother or sister | 26 | | of the consenting birth uncle.
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| 1 | | (m) A registrant
may notify the Registry of his or her
| 2 | | desire not to have identifying information revealed or may | 3 | | revoke any previously
filed Information Exchange Authorization | 4 | | by completing and filing with the
Registry a Registry | 5 | | Identification Form along with a Denial of Information
Exchange | 6 | | or, if applicable, a Birth Parent Preference Form. Any | 7 | | registrant, except a birth parent, may revoke his or her Denial | 8 | | of Information Exchange by filing
an Information Exchange | 9 | | Authorization. A birth parent may revoke a Denial of | 10 | | Information Exchange by filing a Birth Parent Preference Form. | 11 | | Any birth parent who has previously filed a Birth Parent | 12 | | Preference Form where Option E was selected may revoke such | 13 | | preference by filing a subsequent Birth Parent Preference Form | 14 | | and selecting Option A, B, C, or D. The Department of Public | 15 | | Health shall
act in accordance with the most recently filed | 16 | | affidavit.
| 17 | | (n) Identifying information ascertained from the Registry | 18 | | shall be
confidential and may be disclosed only (1) upon a | 19 | | Court Order, which order
shall name the person or persons | 20 | | entitled to the information, or (2) to a registrant who is the | 21 | | subject of an Information Exchange
Authorization or, if | 22 | | applicable, a Birth Parent Preference Form that was completed | 23 | | by another registrant and filed with the Illinois Adoption | 24 | | Registry and Medical Information Exchange, or (3) as authorized | 25 | | under subsection (h) of Section 18.3 of
this Act, or (4) | 26 | | pursuant to the procedures outlined in Section 18.1b(e) of this |
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| 1 | | Act. Any person who willfully provides unauthorized
disclosure | 2 | | of any information filed with the Registry or who knowingly or
| 3 | | intentionally files false information with the Registry shall | 4 | | be guilty of
a Class A misdemeanor and shall be liable for | 5 | | damages.
| 6 | | (o) If information is disclosed pursuant to this Act, the | 7 | | Department shall
redact it to remove any identifying | 8 | | information about any party who has not
consented to the | 9 | | disclosure of such identifying information, or, in the case of | 10 | | identifying information on the original birth certificate, | 11 | | pursuant to Section 18.1b(e) of this Act.
| 12 | | (Source: P.A. 97-110, eff. 7-14-11; 98-704, eff. 1-1-15 .)
| 13 | | (750 ILCS 50/18.2) (from Ch. 40, par. 1522.2)
| 14 | | Sec. 18.2. Forms.
| 15 | | (a) The Department shall develop the Illinois Adoption | 16 | | Registry forms as provided in this Section. The General | 17 | | Assembly shall reexamine the content of the form as requested | 18 | | by the Department, in consultation with the Registry Advisory | 19 | | Council. The form of the Birth Parent Registration
| 20 | | Identification Form shall be substantially as follows:
| 21 | | BIRTH PARENT REGISTRATION IDENTIFICATION
| 22 | | (Insert all known information)
| 23 | | I, ....., state that I am the ...... (mother or father) of the
| 24 | | following child:
| 25 | | Child's original name: ..... (first) ..... (middle) ..... |
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| 1 | | (last),
..... (hour of birth), ..... (date of birth), | 2 | | ..... (city and state of
birth), ..... (name of | 3 | | hospital).
| 4 | | Father's full name: ...... (first) ...... (middle) ..... | 5 | | (last),
..... (date of birth), ..... (city and state of | 6 | | birth).
| 7 | | Name of mother inserted on birth certificate: ..... (first) | 8 | | .....
(middle) ..... (last), ..... (race), ..... (date | 9 | | of birth), ......
(city and state of birth).
| 10 | | That I surrendered my child to: ............. (name of agency), | 11 | | .....
(city and state of agency), ..... (approximate date | 12 | | child surrendered).
| 13 | | That I placed my child by private adoption: ..... (date),
| 14 | | ...... (city
and state).
| 15 | | Name of adoptive parents, if known: ......
| 16 | | Other identifying information: .....
| 17 | | ........................
| 18 | | (Signature of parent)
| 19 | | ............ ........................
| 20 | | (date) (printed name of parent)
| 21 | | (b) The form of the Adopted Person
Registration | 22 | | Identification shall be substantially
as follows:
| 23 | | ADOPTED PERSON
| 24 | | REGISTRATION IDENTIFICATION
| 25 | | (Insert all known information)
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| 1 | | I, ....., state the following:
| 2 | | Adopted Person's present name: ..... (first) ..... | 3 | | (middle)
..... (last).
| 4 | | Adopted Person's name at birth (if known): ..... (first)
| 5 | | ..... (middle) .....
(last), ..... (birth date), ..... | 6 | | (city and state of birth), ......
(sex), ..... (race).
| 7 | | Name of adoptive father: ..... (first) ..... (middle) ..... | 8 | | (last), .....
(race).
| 9 | | Maiden name of adoptive mother: ..... (first) ..... | 10 | | (middle) .....
(last), ..... (race).
| 11 | | Name of birth mother (if known): ..... (first) .....
| 12 | | (middle)
..... (last), ..... (race).
| 13 | | Name of birth father (if known): ..... (first) .....
| 14 | | (middle)
..... (last), ..... (race).
| 15 | | Name(s) at birth of sibling(s) having a common birth
parent | 16 | | with adoptee
(if known): ..... (first) ..... (middle) | 17 | | ..... (last), ..... (race), and name
of common birth | 18 | | parent: ..... (first) ..... (middle) .....
(last),
| 19 | | ..... (race).
| 20 | | I was adopted through: ..... (name of agency).
| 21 | | I was adopted privately: ..... (state "yes" if known).
| 22 | | I was adopted in ..... (city and state), ..... (approximate | 23 | | date).
| 24 | | Other identifying information: .............
| 25 | | ......................
| 26 | | (signature of adoptee)
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| 1 | | ........... .........................
| 2 | | (date) (printed name of adoptee)
| 3 | | (c) The form of the Surrendered Person Registration | 4 | | Identification shall be
substantially as follows:
| 5 | | SURRENDERED PERSON REGISTRATION
| 6 | | IDENTIFICATION
| 7 | | (Insert all known information)
| 8 | | I, ....., state the following:
| 9 | | Surrendered Person's present name: ..... (first) .....
| 10 | | (middle) ..... (last).
| 11 | | Surrendered Person's name at birth (if known): ..... | 12 | | (first)
.....
(middle) ..... (last), .....(birth | 13 | | date), ..... (city and state of
birth), ...... (sex), | 14 | | ..... (race).
| 15 | | Name of guardian father: ..... (first) ..... (middle) ..... | 16 | | (last), .....
(race).
| 17 | | Maiden name of guardian mother: ..... (first) ..... | 18 | | (middle) .....
(last), ..... (race).
| 19 | | Name of birth mother (if known): ..... (first) .....
| 20 | | (middle) .....
(last) ..... (race).
| 21 | | Name of birth father (if known): ..... (first) .....
| 22 | | (middle) .....
(last), .....(race).
| 23 | | Name(s) at birth of sibling(s) having a common birth
parent | 24 | | with surrendered person
(if known): ..... (first) | 25 | | ..... (middle) ..... (last), ..... (race), and name
of |
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| 1 | | common birth parent: ..... (first) ..... (middle) | 2 | | .....
(last),
..... (race).
| 3 | | I was surrendered for adoption to: ..... (name of agency).
| 4 | | I was surrendered for adoption in ..... (city and state), ..... | 5 | | (approximate
date).
| 6 | | Other identifying information: ............
| 7 | | ................................
| 8 | | (signature of surrendered person)
| 9 | | ............ ......................
| 10 | | (date) (printed name of person
| 11 | | surrendered for adoption)
| 12 | | (c-3) The form of the Registration Identification Form for | 13 | | Surviving Relatives of Deceased Birth Parents shall be | 14 | | substantially as follows:
| 15 | | REGISTRATION IDENTIFICATION FORM
| 16 | | FOR SURVIVING RELATIVES OF DECEASED BIRTH PARENTS
| 17 | | (Insert all known information)
| 18 | | I, ....., state the following:
| 19 | | Name of deceased birth parent at time of surrender:
| 20 | | Deceased birth parent's date of birth:
| 21 | | Deceased birth parent's date of death:
| 22 | | Adopted or surrendered person's name at birth (if known): | 23 | | .....(first) ..... (middle) ..... (last), .....(birth | 24 | | date), ..... (city and state of birth), ...... (sex), | 25 | | ..... (race).
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| 1 | | My relationship to the adopted or surrendered person (check | 2 | | one): (birth parent's non-surrendered child) (birth parent's | 3 | | parent) (birth parent's sister) (birth parent's brother).
| 4 | | If you are a non-surrendered child of the birth parent, provide | 5 | | name(s) at birth and age(s) of non-surrendered siblings having | 6 | | a common parent with the birth parent. If more than one | 7 | | sibling, please give information requested below on reverse | 8 | | side of this form. If you are a sibling or parent of the birth | 9 | | parent, provide name(s) at birth and age(s) of the sibling(s) | 10 | | of the birth parent. If more than one sibling, please give | 11 | | information requested below on reverse side of this form.
| 12 | | Name (First) ..... (middle) ..... (last), .....(birth | 13 | | date), ..... (city and state of birth), ...... (sex), | 14 | | ..... (race).
| 15 | | Name(s) of common parent(s) (first) ..... (middle) ..... | 16 | | (last), .....(race), (first) ..... (middle) ..... | 17 | | (last), .....(race).
| 18 | | My birth sibling/child of my brother/child of my sister/ was | 19 | | surrendered for adoption to ..... (name of agency) City and | 20 | | state of agency ..... Date .....(approximate) Other | 21 | | identifying information ..... (Please note that you must: (i) | 22 | | be at least 21 years of age to register; (ii) submit with your | 23 | | registration a certified copy of the birth parent's birth | 24 | | certificate; (iii) submit a certified copy of the birth | 25 | | parent's death certificate; and (iv) if you are a |
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| 1 | | non-surrendered birth sibling or a sibling of the deceased | 2 | | birth parent, also submit a certified copy of your birth | 3 | | certificate with this registration. No application from a | 4 | | surviving relative of a deceased birth parent can be accepted | 5 | | if the birth parent filed a Denial of Information Exchange | 6 | | prior to his or her death.)
| 7 | | ................................
| 8 | | (signature of birth parent's surviving relative)
| 9 | | ............ ............ | 10 | | (date) (printed name of birth | 11 | | parent's surviving relative) | 12 | | (c-5) The form of the Registration Identification Form for | 13 | | Surviving Relatives of Deceased Adopted or Surrendered Persons | 14 | | shall be substantially as follows:
| 15 | | REGISTRATION IDENTIFICATION FORM FOR
| 16 | | SURVIVING RELATIVES OF DECEASED ADOPTED OR SURRENDERED PERSONS
| 17 | | (Insert all known information)
| 18 | | I, ....., state the following:
| 19 | | Adopted or surrendered person's name at birth (if known): | 20 | | (first) ..... (middle) ..... (last), .....(birth | 21 | | date), ..... (city and state of birth), ...... (sex), | 22 | | ..... (race). | 23 | | Adopted or surrendered person's date of death:
| 24 | | My relationship to the deceased adopted or surrendered |
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| 1 | | person(check one): (adoptive mother) (adoptive father) (adult | 2 | | child) (surviving spouse).
| 3 | | If you are an adult child or surviving spouse of the adopted or | 4 | | surrendered person, provide name(s) at birth and age(s) of the | 5 | | children of the adopted or surrendered person. If the adopted | 6 | | or surrendered person had more than one child, please give | 7 | | information requested below on reverse side of this form. | 8 | | Name (first) ..... (middle) ..... (last), .....(birth | 9 | | date), ..... (city and state of birth), ...... (sex), | 10 | | ..... (race). | 11 | | Name(s) of common parent(s) (first) ..... (middle) ..... | 12 | | (last), .....(race), (first) ..... (middle) ..... | 13 | | (last), .....(race).
| 14 | | My child/parent/deceased spouse was surrendered for | 15 | | adoption to .....(name of agency) City and state of agency | 16 | | ..... Date ..... (approximate) Other identifying | 17 | | information ..... (Please note that you must: (i) be at | 18 | | least 21 years of age to register; (ii) submit with your | 19 | | registration a certified copy of the adopted or surrendered | 20 | | person's death certificate; (iii) if you are the child of a | 21 | | deceased adopted or surrendered person, also submit a | 22 | | certified copy of your birth certificate with this | 23 | | registration; and (iv) if you are the surviving wife or | 24 | | husband of a deceased adopted or surrendered person, also | 25 | | submit a copy of your marriage certificate with this | 26 | | registration. No application from a surviving relative of a |
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| 1 | | deceased adopted or surrendered person can be accepted if | 2 | | the adopted or surrendered person filed a Denial of | 3 | | Information Exchange prior to his or her death.)
| 4 | | ................................
| 5 | | (signature of adopted or surrendered person's surviving
| 6 | | relative)
| 7 | | ............ ............ | 8 | | (date) (printed name of adopted
| 9 | | person's surviving relative)
| 10 | | (d) The form of the Information Exchange Authorization | 11 | | shall be
substantially
as follows:
| 12 | | INFORMATION EXCHANGE AUTHORIZATION
| 13 | | I, ....., state that I am the person who completed the | 14 | | Registration
Identification; that I am of the age of ..... | 15 | | years; that I hereby
authorize the Department of Public Health | 16 | | to give to the following person(s)
(birth mother)
(birth | 17 | | father) (birth sibling) (adopted or surrendered person) | 18 | | (adoptive mother) (adoptive father) (legal guardian of an | 19 | | adopted or surrendered person) (birth grandparent) (birth | 20 | | aunt) (birth uncle) (adult child of a deceased adopted or | 21 | | surrendered person) (surviving spouse of a deceased adopted or | 22 | | surrendered person) (all eligible relatives) the following
| 23 | | (please check the
information
authorized for exchange):
|
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| 1 | | [ ] 1. Only my name and last known address.
| 2 | | [ ] 2. A copy of my Illinois Adoption Registry | 3 | | Application.
| 4 | | [ ] 3. A non-certified copy of the adopted or | 5 | | surrendered person's original certificate of live birth | 6 | | (check only if you are an adopted or surrendered person or | 7 | | the surviving adult child or surviving spouse of a deceased | 8 | | adopted or surrendered person).
| 9 | | [ ] 4. A copy of my completed medical questionnaire.
| 10 | | I am fully aware that I can only be supplied with
| 11 | | information about an individual or individuals who have
duly
| 12 | | executed an Information Exchange Authorization that
has
not | 13 | | been revoked or, if I am an adopted or surrendered person, from | 14 | | a birth parent who completed a Birth Parent Preference Form and | 15 | | did not prohibit the release of his or her identity to me; that | 16 | | I can be contacted by writing to: ..... (own name or
name of | 17 | | person to contact) (address) (phone number).
| 18 | | NOTE: New IARMIE registrants who do not complete a Medical | 19 | | Information Exchange Questionnaire and release a copy of their | 20 | | questionnaire to at least one Registry applicant must pay a $15 | 21 | | registration fee. | 22 | | Dated (insert date).
| 23 | | .............. | 24 | | (signature)
| 25 | | (e) The form of the Denial of Information Exchange shall be
|
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| 1 | | substantially as follows:
| 2 | | DENIAL OF INFORMATION EXCHANGE
| 3 | | I, ....., state that I am the person who completed the | 4 | | Registration
Identification; that I am of the age of ..... | 5 | | years; that I hereby
instruct the Department of Public Health | 6 | | not to give any identifying
information about me to the | 7 | | following person(s)
(birth mother) (birth father) (birth | 8 | | sibling) (adopted or surrendered person) (adoptive mother) | 9 | | (adoptive father) (legal guardian of an adopted or surrendered | 10 | | person) (birth grandparent) (birth aunt) (birth uncle) (adult | 11 | | child of a deceased adopted or surrendered person) (surviving | 12 | | spouse of a deceased adopted or surrendered person) (all | 13 | | eligible relatives).
| 14 | | I do/do not (circle appropriate response) authorize the | 15 | | Registry to release a copy of my completed Medical Information | 16 | | Exchange Questionnaire to qualified Registry applicants.
NOTE: | 17 | | New IARMIE registrants who do not complete a Medical | 18 | | Information Exchange Questionnaire and release a copy of their | 19 | | questionnaire to at least one Registry applicant must pay a $15 | 20 | | registration fee.
Birth parents filing a Denial of Information | 21 | | Exchange are advised that, under Illinois law, an adult adopted | 22 | | person may initiate a search for a birth parent who has filed a | 23 | | Denial of Information Exchange or Birth Parent Preference Form | 24 | | on which Option E was selected through the State confidential | 25 | | intermediary program once 5 years have elapsed since the filing | 26 | | of the Denial of Information Exchange or Birth Parent |
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| 1 | | Preference Form.
| 2 | | Dated (insert date).
| 3 | | ............... | 4 | | (signature)
| 5 | | (f) The form of the Birth Parent Preference Form shall be | 6 | | substantially as follows: | 7 | | In recognition of the basic right of all persons to access | 8 | | their birth records, Illinois law now provides for the release | 9 | | of original birth certificates to adopted and surrendered | 10 | | persons 21 years of age or older upon request. While many birth | 11 | | parents are comfortable sharing their identities or initiating | 12 | | contact with their birth sons and daughters once they have | 13 | | reached adulthood, Illinois law also recognizes that there may | 14 | | be unique situations where a birth parent might have a | 15 | | compelling reason for not wishing to establish contact with a | 16 | | birth son or birth daughter or for not wishing to release | 17 | | identifying information that appears on the original birth | 18 | | certificate of a birth son or birth daughter who has reached | 19 | | adulthood. The Illinois Adoption Registry and Medical | 20 | | Information Exchange (IARMIE) has therefore established the | 21 | | attached form to allow birth parents to express their | 22 | | preferences regarding contact; and, if their birth child was | 23 | | born on or after January 1, 1946, to express their wishes | 24 | | regarding the sharing of identifying information listed on the | 25 | | original birth certificate with an adult adopted or surrendered |
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| 1 | | person who has reached the age of 21 or his or her surviving | 2 | | relatives. | 3 | | In selecting one of the 5 options below, birth parents | 4 | | should keep in mind that the decision to deny an adult adopted | 5 | | or surrendered person access to identifying information on his | 6 | | or her original birth record and/or information about | 7 | | genetically-transmitted diseases is an important decision that | 8 | | may impact the adopted or surrendered person's life in many | 9 | | ways. A request for anonymity on this form only pertains to | 10 | | information that is provided to an adult adopted or surrendered | 11 | | person or his or her surviving relatives through the Registry. | 12 | | This will not prevent the disclosure of identifying information | 13 | | that may be available to the adoptee through his or her | 14 | | adoptive parents and/or other means available to him or her. | 15 | | Birth parents who would prefer not to be contacted by their | 16 | | surrendered son or daughter are strongly urged to complete both | 17 | | the Non-Identifying Information Section included on the final | 18 | | page of the attached form and the Medical Questionnaire in | 19 | | order to provide their surrendered son or daughter with the | 20 | | background information he or she may need to better understand | 21 | | his or her origins. Birth parents whose birth son or birth | 22 | | daughter is under 21 years of age at the time of the completion | 23 | | of this form are reminded that no original birth certificate | 24 | | will be released by the IARMIE before an adoptee has reached | 25 | | the age of 21. Should you need additional assistance in | 26 | | completing this form, please contact the agency that handled |
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| 1 | | the adoption, if applicable, or the Illinois Adoption Registry | 2 | | and Medical Information Exchange at 877-323-5299. | 3 | | After careful consideration, I have made the following | 4 | | decision regarding contact with my birth son/birth daughter, | 5 | | (insert birth son's/birth daughter's name at birth, if | 6 | | applicable) ......, who was born in (insert city/town of birth) | 7 | | ...... on (insert date of birth)...... and the release of my | 8 | | identifying information as it appears on his/her original birth | 9 | | certificate when he/she reaches the age of 21, and I have | 10 | | chosen Option ...... (insert A, B, C, D, or E, as applicable). | 11 | | I realize that this form must be accompanied by a completed | 12 | | IARMIE application form as well as a Medical Information | 13 | | Exchange Questionnaire or the $15 registration fee. I am also | 14 | | aware that I may revoke this decision at any time by completing | 15 | | a new Birth Parent Preference Form and filing it with the | 16 | | IARMIE. I understand that it is my responsibility to update the | 17 | | IARMIE with any changes to contact information provided below. | 18 | | I also understand that, while preferences regarding the release | 19 | | of identifying information through the Registry are binding | 20 | | unless the law should change in the future, any selection I | 21 | | have made regarding my preferred method of contact is not. | 22 | | ... | 23 | | (Signature/Date) | 24 | | (Please insert your signature and today's date above, as well | 25 | | as under your chosen option, A, B, C, D, or E below.) |
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| 1 | | Option A. My birth son or birth daughter was born on or after | 2 | | January 1, 1946, and I agree to the release of my identifying | 3 | | information as it appears on my birth son's/birth daughter's | 4 | | original birth certificate, OR my birth son or birth daughter | 5 | | was born prior to January 1, 1946. I would welcome direct | 6 | | contact with my birth son/birth daughter when he or she has | 7 | | reached the age of 21. In addition, before my birth son or | 8 | | birth daughter has reached the age of 21 or in the event of his | 9 | | or her death, I would welcome contact with the following | 10 | | relatives of my birth child (circle all that apply): adoptive | 11 | | mother, adoptive father, surviving spouse, surviving adult | 12 | | child. I wish to be contacted at the following mailing address, | 13 | | email address or phone number: | 14 | | .............................. | 15 | | ............................................................. | 16 | | ............................................................. | 17 | | ............................................................. | 18 | | (Signature/Date) | 19 | | Option B. My birth son or birth daughter was born on or after | 20 | | January 1, 1946, and I agree to the release of my identifying | 21 | | information as it appears on my birth son's/birth daughter's | 22 | | original birth certificate, OR my birth son or birth daughter | 23 | | was born prior to January 1, 1946. I would welcome contact with | 24 | | my birth son/birth daughter when he or she has reached the age |
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| 1 | | of 21. In addition, before my birth son or birth daughter has | 2 | | reached the age of 21 or in the event of his or her death, I | 3 | | would welcome contact with the following relatives of my birth | 4 | | child (circle all that apply): adoptive mother, adoptive | 5 | | father, surviving spouse, surviving adult child. I would prefer | 6 | | to be contacted through the following person. (Insert name and | 7 | | mailing address, email address or phone number of chosen | 8 | | contact person.) | 9 | | ............................................ | 10 | | ............................................................. | 11 | | (Signature/Date) | 12 | | Option C. My birth son or birth daughter was born on or after | 13 | | January 1, 1946, and I agree to the release of my identifying | 14 | | information as it appears on my birth son's/birth daughter's | 15 | | original birth certificate, OR my birth son or birth daughter | 16 | | was born prior to January 1, 1946. I would welcome contact with | 17 | | my birth son/birth daughter when he or she has reached the age | 18 | | of 21. In addition, before my birth son or birth daughter has | 19 | | reached the age of 21 or in the event of his or her death, I | 20 | | would welcome contact with the following relatives of my birth | 21 | | child (circle all that apply): adoptive mother, adoptive | 22 | | father, surviving spouse, surviving adult child. I would prefer | 23 | | to be contacted through the Illinois Confidential Intermediary | 24 | | Program (please call 800-526-9022 for additional information) | 25 | | or through the agency that handled the adoption. (Insert agency |
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| 1 | | name, address and phone number, if applicable.) | 2 | | ............. | 3 | | ............................................................. | 4 | | (Signature/Date) | 5 | | Option D. My birth son or birth daughter was born on or after | 6 | | January 1, 1946, and I agree to the release of my identifying | 7 | | information as it appears on my birth son's/birth daughter's | 8 | | original birth certificate when he or she has reached the age | 9 | | of 21, OR my birth son or birth daughter was born prior to | 10 | | January 1, 1946. I would prefer not to be contacted by my birth | 11 | | son/birth daughter or his or her adoptive parents or surviving | 12 | | relatives. | 13 | | ................................................... | 14 | | (Signature/Date) | 15 | | Option E. My birth son or birth daughter was born on or after | 16 | | January 1, 1946, and I wish to prohibit the release of my | 17 | | (circle ALL applicable options) first name, last name, last | 18 | | known address, birth son/birth daughter's last name (if last | 19 | | name listed is same as mine), as they appear on my birth | 20 | | son's/birth daughter's original birth certificate and do not | 21 | | wish to be contacted by my birth son/birth daughter when he or | 22 | | she has reached the age of 21. If there were any special | 23 | | circumstances that played a role in your decision to remain | 24 | | anonymous which you would like to share with your birth |
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| 1 | | son/birth daughter, please list them in the space provided | 2 | | below (optional). | 3 | | ........................................... | 4 | | ............................................................. | 5 | | I understand that, although I have chosen to prohibit the | 6 | | release of my identity on the non-certified copy of the | 7 | | original birth certificate released to my birth son/birth | 8 | | daughter, he or she may request that a court-appointed | 9 | | confidential intermediary contact me to request updated | 10 | | medical information and/or confirm my desire to remain | 11 | | anonymous once 5 years have elapsed since the signing of this | 12 | | form; at the time of this subsequent search, I wish to be | 13 | | contacted through the person named below. (Insert in blank area | 14 | | below the name and phone number of the contact person, or leave | 15 | | it blank if you wish to be contacted directly.) I also | 16 | | understand that this request for anonymity shall expire upon my | 17 | | death. | 18 | | ...................................................... | 19 | | ............................................................. | 20 | | (Signature/Date) | 21 | | NOTE: A copy of this form will be forwarded to your birth son | 22 | | or birth daughter should he or she file a request for his or | 23 | | her original birth certificate with the IARMIE. However, if you | 24 | | have selected Option E, identifying information, per your | 25 | | specifications above, will be deleted from the copy of this |
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| 1 | | form forwarded to your birth son or daughter during your | 2 | | lifetime. In the event that an adopted or surrendered person is | 3 | | deceased, his or her surviving adult children may request a | 4 | | copy of the adopted or surrendered person's original birth | 5 | | certificate providing they have registered with the IARMIE; the | 6 | | copy of this form and the non-certified copy of the original | 7 | | birth certificate forwarded to the surviving child of the | 8 | | adopted or surrendered person shall be redacted per your | 9 | | specifications on this form during your lifetime. | 10 | | Non-Identifying Information Section
| 11 | | I wish to voluntarily provide the following non-identifying | 12 | | information to my birth son or birth daughter:
| 13 | | My age at the time of my child's birth was .........
| 14 | | My race is best described as: .......................... | 15 | | My height is: ......... | 16 | | My body type is best described as (circle one): slim, average, | 17 | | muscular, a few extra pounds, or more than a few extra pounds.
| 18 | | My natural hair color is/was: .................. | 19 | | My eye color is: .................. | 20 | | My religion is best described as: ..................
| 21 | | My ethnic background is best described as: ..................
| 22 | | My educational level is closest to (circle applicable | 23 | | response): completed elementary school, graduated from | 24 | | high school, attended college, earned bachelor's degree, | 25 | | earned master's degree, earned doctoral degree.
| 26 | | My occupation is best described as .................. |
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| 1 | | My hobbies include .................. | 2 | | My interests include .................. | 3 | | My talents include .................. | 4 | | In addition to my surrendered son or daughter, I also | 5 | | am the biological parent of (insert number) ....... boys and | 6 | | (insert number) ....... girls, of whom (insert number) ....... | 7 | | are still living.
| 8 | | The relationship between me and my child's birth mother/birth | 9 | | father would best be described as (circle appropriate | 10 | | response): husband and wife, ex-spouses, boyfriend and | 11 | | girlfriend, casual acquaintances, other (please specify) | 12 | | .............. | 13 | | (g) The form of the Request for a Non-Certified Copy of an | 14 | | Original Birth Certificate shall be substantially as follows: | 15 | | REQUEST FOR A NON-CERTIFIED COPY OF AN ORIGINAL BIRTH | 16 | | CERTIFICATE | 17 | | I, (requesting party's full name) ....., hereby request a | 18 | | non-certified copy of (check appropriate option) ..... my | 19 | | original birth certificate ..... the original birth | 20 | | certificate of my deceased adopted or surrendered parent ..... | 21 | | the original birth certificate of my deceased adopted or | 22 | | surrendered spouse (insert deceased parent's/deceased spouse's | 23 | | name at adoption) ...... I/my deceased parent/my deceased | 24 | | spouse was born in (insert city and county of adopted or | 25 | | surrendered person's birth) ..... on ..... (insert adopted or | 26 | | surrendered person's date of birth). In the event that one or |
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| 1 | | both of my/my deceased parent's/my deceased spouse's birth | 2 | | parents has requested that their identity not be released to | 3 | | me/to my deceased parent/to my deceased spouse, I wish to | 4 | | (check appropriate option) ..... a. receive a non-certified | 5 | | copy of the original birth certificate from which identifying | 6 | | information pertaining to the birth parent who requested | 7 | | anonymity has been deleted; or ..... b. I do not wish to | 8 | | receive received an altered copy of the original birth | 9 | | certificate. | 10 | | Dated (insert date). | 11 | | ................... | 12 | | (signature)
| 13 | | (h) Any Information Exchange Authorization, Denial of | 14 | | Information
Exchange, or Birth Parent Preference Form filed | 15 | | with the Registry, or Request for a Non-Certified Copy of an | 16 | | Original Birth Certificate filed with the Registry by a | 17 | | surviving adult child or surviving spouse of a deceased adopted | 18 | | or surrendered person, shall be acknowledged by the person who | 19 | | filed it before a notary
public, in form
substantially as | 20 | | follows:
| 21 | | State of ..............
| 22 | | County of .............
| 23 | | I, a Notary Public, in and for the said County, in the | 24 | | State aforesaid,
do hereby certify that ............... | 25 | | personally known to me to be the
same person whose name is |
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| 1 | | subscribed to the foregoing certificate of
acknowledgement, | 2 | | appeared before me in person and acknowledged that (he or
she) | 3 | | signed such certificate as (his or her) free and voluntary act | 4 | | and
that the statements in such certificate are true.
| 5 | | Given under my hand and notarial seal on (insert date).
| 6 | | .........................
| 7 | | (signature)
| 8 | | (i) When the execution of an Information Exchange
| 9 | | Authorization, Denial of Information Exchange, or Birth Parent | 10 | | Preference Form or Request for a Non-Certified Copy of an | 11 | | Original Birth Certificate completed by a surviving adult child | 12 | | or surviving spouse of a deceased adopted or surrendered person | 13 | | is acknowledged before a
representative of an agency, such | 14 | | representative shall have his signature
on said Certificate | 15 | | acknowledged before a notary public, in form substantially
as | 16 | | follows:
| 17 | | State of..........
| 18 | | County of.........
| 19 | | I, a Notary Public, in and for the said County, in the | 20 | | State aforesaid,
do hereby certify that ..... personally known | 21 | | to me to be the same person
whose name is subscribed to the | 22 | | foregoing certificate of acknowledgement,
appeared before me | 23 | | in person and acknowledged that (he or she) signed such
| 24 | | certificate as (his or her) free and voluntary act and that the | 25 | | statements
in such certificate are true.
|
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| 1 | | Given under my hand and notarial seal on (insert date).
| 2 | | .......................
| 3 | | (signature)
| 4 | | (j) When an Illinois Adoption Registry Application,
| 5 | | Information
Exchange Authorization, Denial of
Information | 6 | | Exchange, Birth Parent Preference Form, or Request for a | 7 | | Non-Certified Copy of an Original Birth Certificate completed | 8 | | by a surviving adult child or surviving spouse of a deceased | 9 | | adopted or surrendered person is executed in a foreign country, | 10 | | the
execution of such
document shall be acknowledged or | 11 | | affirmed before an officer of the United
States consular | 12 | | services.
| 13 | | (k) If the person signing an Information Exchange
| 14 | | Authorization, Denial of Information, Birth Parent Preference | 15 | | Form, or Request for a Non-Certified Copy of an Original Birth | 16 | | Certificate completed by a surviving adult child or surviving | 17 | | spouse of a deceased adopted or surrendered person is in the | 18 | | military service of the
United States, the execution of such | 19 | | document may be acknowledged before a
commissioned officer and | 20 | | the signature of such officer on such certificate
shall be | 21 | | verified or acknowledged before a notary public or by such | 22 | | other
procedure as is then in effect for such division or | 23 | | branch of the armed forces.
| 24 | | (l) An adopted or surrendered person, surviving adult | 25 | | child, adult grandchild, surviving spouse, or birth parent of |
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| 1 | | an adult adopted person who completes a Request For a | 2 | | Non-Certified Copy of the Original Birth Certificate shall meet | 3 | | the same filing requirements and pay the same filing fees as a | 4 | | non-adopted person seeking to obtain a copy of his or her | 5 | | original birth certificate.
| 6 | | (m) Beginning on January 1, 2015, any birth parent of an | 7 | | adult adopted person named on the original birth certificate | 8 | | may request a non-certified copy of the original birth | 9 | | certificate reflecting the birth of the adult adopted person, | 10 | | provided that: | 11 | | (1) any non-certified copy of the original birth | 12 | | certificate released under this subsection (m) shall not | 13 | | reflect the State file number on the original birth | 14 | | certificate; and | 15 | | (2) if the Department of Public Health does not locate | 16 | | the original birth certificate, it shall issue a | 17 | | certification of no record found. | 18 | | (Source: P.A. 97-110, eff. 7-14-11; 98-704, eff. 1-1-15; | 19 | | revised 12-10-14.)
| 20 | | (750 ILCS 50/18.3a) (from Ch. 40, par. 1522.3a)
| 21 | | Sec. 18.3a. Confidential intermediary.
| 22 | | (a) General purposes.
Notwithstanding any other provision | 23 | | of
this Act, | 24 | | (1) any
adopted or surrendered person 21 years of age | 25 | | or over; or |
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| 1 | | (2) any adoptive parent or legal guardian
of
an adopted | 2 | | or surrendered person under the age of 21; or | 3 | | (3) any birth parent of an adopted
or surrendered | 4 | | person who is 21 years of age or over; or | 5 | | (4) any adult child or adult grandchild of a deceased | 6 | | adopted or surrendered person; or | 7 | | (5) any adoptive parent or surviving spouse of a | 8 | | deceased adopted or surrendered person; or | 9 | | (6) any adult birth sibling of the adult adopted or | 10 | | surrendered person unless the birth parent has checked | 11 | | Option E on the Birth Parent Preference Form or has filed a | 12 | | Denial of Information Exchange with the Registry and is not | 13 | | deceased; or | 14 | | (7) any adult adopted birth sibling of an adult adopted | 15 | | or surrendered person; or | 16 | | (8) any adult birth sibling of the birth parent if the | 17 | | birth parent is deceased ; or | 18 | | (9) any birth grandparent | 19 | | may petition the court in any county in
the
State of Illinois | 20 | | for appointment of a confidential intermediary as provided in
| 21 | | this Section for the purpose of exchanging medical information | 22 | | with one or
more mutually consenting biological relatives, | 23 | | obtaining identifying
information about one or more mutually | 24 | | consenting biological relatives, or
arranging contact with one | 25 | | or more mutually consenting biological relatives.
The | 26 | | petitioner shall be required to accompany his or her petition |
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| 1 | | with proof of registration with the Illinois Adoption Registry | 2 | | and Medical Information Exchange.
| 3 | | (b) Petition. Upon petition, the
court
shall appoint a | 4 | | confidential intermediary.
The petition shall indicate if the | 5 | | petitioner wants to do any
one or more of the following as to | 6 | | the sought-after relative or relatives: exchange medical | 7 | | information with the
biological relative or relatives, obtain | 8 | | identifying information from the
biological relative or | 9 | | relatives, or to arrange contact with the biological
relative.
| 10 | | (c) Order. The order appointing the confidential | 11 | | intermediary shall allow
that
intermediary to conduct a search | 12 | | for the sought-after relative by accessing
those records | 13 | | described in subsection (g) of this Section.
| 14 | | (d) Fees and expenses. The court shall not condition the | 15 | | appointment of the
confidential intermediary on the payment of | 16 | | the intermediary's
fees and expenses in advance of the | 17 | | commencement of the work of the
confidential intermediary. No | 18 | | fee shall be charged to any petitioner.
| 19 | | (e) Eligibility of intermediary. The court may appoint as | 20 | | confidential
intermediary any
person certified by the | 21 | | Department of Children and Family Services as qualified to | 22 | | serve as a confidential
intermediary.
Certification shall be | 23 | | dependent upon the
confidential intermediary completing a | 24 | | course of training including, but not
limited to, applicable | 25 | | federal and State privacy laws.
| 26 | | (f) (Blank).
|
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| 1 | | (g) Confidential intermediary access to information. | 2 | | Subject to the limitations of subsection (i) of this
Section, | 3 | | the
confidential
intermediary shall have access to vital | 4 | | records maintained by the Department of
Public Health and its | 5 | | local designees for the maintenance of vital records, or a | 6 | | comparable public entity that maintains vital records in | 7 | | another state in accordance with that state's laws, and
all | 8 | | records of the court or any adoption agency,
public
or private, | 9 | | as limited in this Section, which relate to the adoption or the | 10 | | identity and location of an
adopted or surrendered person, of | 11 | | an adult child or surviving spouse of a deceased adopted or | 12 | | surrendered person, or of a birth
parent, birth sibling, or the | 13 | | sibling of a deceased birth parent. The
confidential | 14 | | intermediary shall not have access to any personal health
| 15 | | information protected by the Standards for Privacy of | 16 | | Individually
Identifiable Health Information adopted by the | 17 | | U.S. Department of Health and
Human Services under the Health | 18 | | Insurance Portability and Accountability Act of
1996 unless the | 19 | | confidential intermediary has obtained written consent from | 20 | | the
person whose information is being sought by an adult | 21 | | adopted or surrendered person or, if that person is a minor | 22 | | child,
that person's parent or guardian. Confidential
| 23 | | intermediaries shall be authorized to inspect confidential | 24 | | relinquishment and
adoption records. The confidential | 25 | | intermediary shall not be authorized to
access medical
records, | 26 | | financial records, credit records, banking records, home |
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| 1 | | studies,
attorney file records, or other personal records.
In | 2 | | cases where a birth parent is being sought, an adoption agency | 3 | | shall inform
the confidential intermediary of any statement | 4 | | filed pursuant to Section 18.3, hereinafter referred to as "the | 5 | | 18.3 statement",
indicating a desire of the surrendering birth | 6 | | parent to have identifying
information shared or to not have | 7 | | identifying information shared. Information
provided to the | 8 | | confidential intermediary by an adoption agency shall be
| 9 | | restricted to the full name, date of birth, place of birth, | 10 | | last known address,
last known telephone number of the | 11 | | sought-after relative or, if applicable,
of the children or | 12 | | siblings of the sought-after relative, and the 18.3 statement. | 13 | | If the petitioner is an adult adopted or surrendered person or | 14 | | the adoptive parent of a minor and if the petitioner has signed | 15 | | a written authorization to disclose personal medical | 16 | | information, an adoption agency disclosing information to a | 17 | | confidential intermediary shall disclose available medical | 18 | | information about the adopted or surrendered person from birth | 19 | | through adoption.
| 20 | | (h) Missing or lost original birth certificate; remedy. | 21 | | Disclosure of information by the confidential intermediary | 22 | | shall be consistent with the public policy and intent of laws | 23 | | granting original birth certificate access as expressed in | 24 | | Section 18.04 of this Act. The confidential intermediary shall | 25 | | comply with the following procedures in disclosing information | 26 | | to the petitioners: |
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| 1 | | (1) If the petitioner is an adult adopted or | 2 | | surrendered person, or the adult child, adult grandchild, | 3 | | or surviving spouse of a deceased adopted or surrendered | 4 | | person, the confidential intermediary shall disclose: | 5 | | (A) identifying information about the birth parent | 6 | | of the adopted person which, in the ordinary course of | 7 | | business, would have been reflected on the original | 8 | | filed certificate of birth, as of the date of birth, | 9 | | only if: | 10 | | (i) the adopted person was born before January | 11 | | 1, 1946 and the petitioner has requested a | 12 | | non-certified copy of the adopted person's | 13 | | original birth certificate under Section 18.1 of | 14 | | this Act, and the Illinois Department of Public | 15 | | Health has issued a certification that the | 16 | | original birth certificate was not found, or the | 17 | | petitioner has presented the confidential | 18 | | intermediary with the non-certified copy of the | 19 | | original birth certificate which omits the name of | 20 | | the birth parent; | 21 | | (ii) the adopted person was born after January | 22 | | 1, 1946, and the petitioner has requested a | 23 | | non-certified copy of the adopted person's | 24 | | original birth certificate under Section 18.1 of | 25 | | this Act and the Illinois Department of Public | 26 | | Health has issued a certification that the |
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| 1 | | original birth certificate was not found. | 2 | | In providing information pursuant to this | 3 | | subdivision (h)(1)(A), the confidential intermediary | 4 | | shall expressly inform the petitioner in writing that | 5 | | since the identifying information is not from an | 6 | | official original certificate of birth filed pursuant | 7 | | to the Vital Records Act, the confidential | 8 | | intermediary cannot attest to the complete accuracy of | 9 | | the information and the confidential intermediary | 10 | | shall not be liable if the information disclosed is not | 11 | | accurate. Only information from the court files shall | 12 | | be provided to the petitioner in this Section. If the | 13 | | identifying information concerning a birth father is | 14 | | sought by the petitioner, the confidential | 15 | | intermediary shall disclose only the identifying | 16 | | information of the birth father as defined in Section | 17 | | 18.06 of this Act; | 18 | | (B) the name of the child welfare agency which had | 19 | | legal custody of the surrendered person or | 20 | | responsibility for placing the surrendered person and | 21 | | any available contact information for such agency; | 22 | | (C) the name of the state in which the surrender | 23 | | occurred or in which the adoption was finalized; and | 24 | | (D) any information for which the sought-after | 25 | | relative has provided his or her consent to disclose | 26 | | under paragraphs (1) through (4) of subsection (i) of |
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| 1 | | this Section. | 2 | | (2) If the petitioner is an adult adopted or | 3 | | surrendered person, or the adoptive parent of an adult | 4 | | adopted or surrendered person under the age of 21, or the | 5 | | adoptive parent of a deceased adopted or surrendered | 6 | | person, the confidential intermediary shall provide, in | 7 | | addition to the information listed in paragraph (1) of this | 8 | | subsection (h): | 9 | | (A) any information which the adoption agency | 10 | | provides pursuant to subsection (i) of this Section | 11 | | pertaining to medical information about the adopted or | 12 | | surrendered person; and | 13 | | (B) any non-identifying information, as defined in | 14 | | Section 18.4 of this Act, that is obtained during the | 15 | | search. | 16 | | (3) If the petitioner is not defined in paragraph (1) | 17 | | or (2) of this subsection, the confidential intermediary | 18 | | shall provide to the petitioner: | 19 | | (A) any information for which the sought-after | 20 | | relative has provided his or her consent under | 21 | | paragraphs (1) through (4) of subsection (i) of this | 22 | | Section; | 23 | | (B) the name of the child welfare agency which had | 24 | | legal custody of the surrendered person or | 25 | | responsibility for placing the surrendered person and | 26 | | any available contact information for such agency; and |
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| 1 | | (C) the name of the state in which the surrender | 2 | | occurred or in which the adoption was finalized.
| 3 | | (h-5) Disclosure of information shall be made by the | 4 | | confidential intermediary at any time from the appointment of | 5 | | the confidential intermediary and the court's issuance of an | 6 | | order of dismissal. | 7 | | (i) Duties of confidential intermediary in conducting a | 8 | | search. In
conducting
a search under this Section, the | 9 | | confidential intermediary shall first determine whether there | 10 | | is a Denial of Information Exchange or a Birth Parent | 11 | | Preference Form with Option E selected or an 18.3 statement | 12 | | referenced in subsection (g) of this Section on file with the | 13 | | Illinois
Adoption Registry. If there is a denial, the Birth | 14 | | Parent Preference Form on file with the Registry and the birth | 15 | | parent who completed the form selected Option E, or if there is | 16 | | an 18.3 statement indicating the birth parent's intent not to | 17 | | have identifying information shared and the birth parent did | 18 | | not later file an Information Exchange Authorization with the | 19 | | Registry, the confidential intermediary must discontinue the | 20 | | search unless 5 years or more have elapsed since the execution | 21 | | of the Denial of Information Exchange, Birth Parent Preference | 22 | | Form, or the 18.3 statement. If a birth parent was previously | 23 | | the subject of a search through the State confidential | 24 | | intermediary program, the confidential intermediary shall | 25 | | inform the petitioner of the need to discontinue the search | 26 | | until 10 years or more have elapsed since the initial search |
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| 1 | | was closed. In cases where a birth parent has been the object | 2 | | of 2 searches through the State confidential intermediary | 3 | | program, no subsequent search for the birth parent shall be | 4 | | authorized absent a court order to the contrary.
| 5 | | In conducting a search under this Section, the confidential | 6 | | intermediary
shall attempt to locate the relative or relatives | 7 | | from whom the petitioner has
requested information. If the | 8 | | sought-after relative is deceased
or cannot be located after a | 9 | | diligent search, the
confidential intermediary may contact | 10 | | other adult relatives of the
sought-after relative.
| 11 | | The confidential intermediary shall contact a sought-after | 12 | | relative on
behalf of the petitioner in a manner that respects | 13 | | the sought-after relative's
privacy and shall inform the | 14 | | sought-after relative of the petitioner's request
for medical | 15 | | information, identifying information or contact as stated in | 16 | | the
petition. Based upon the terms of the petitioner's request, | 17 | | the confidential
intermediary shall contact a sought-after | 18 | | relative on behalf of the petitioner
and inform the | 19 | | sought-after relative of the following options:
| 20 | | (1) The sought-after relative may totally reject one or | 21 | | all of the
requests for medical information, identifying | 22 | | information or
contact. The sought-after relative shall be | 23 | | informed that they can
provide a medical questionnaire to | 24 | | be forwarded to the petitioner
without releasing any | 25 | | identifying information. The confidential
intermediary | 26 | | shall inform the petitioner of the sought-after
relative's |
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| 1 | | decision to reject the sharing of information or contact.
| 2 | | (2) The sought-after relative may consent to | 3 | | completing a medical
questionnaire only. In this case, the | 4 | | confidential intermediary
shall provide the questionnaire | 5 | | and ask the sought-after relative to
complete it. The | 6 | | confidential intermediary shall forward the
completed | 7 | | questionnaire to the petitioner and inform the petitioner
| 8 | | of the sought-after relative's desire to not provide any | 9 | | additional
information.
| 10 | | (3) The sought-after relative may communicate with the | 11 | | petitioner
without having his or her identity disclosed. In | 12 | | this case, the
confidential intermediary shall arrange the | 13 | | desired communication
in a manner that protects the | 14 | | identity of the sought-after relative.
The confidential | 15 | | intermediary shall inform the petitioner of the
| 16 | | sought-after relative's decision to communicate but not | 17 | | disclose
his or her identity.
| 18 | | (4) The sought-after relative may consent to initiate | 19 | | contact with the
petitioner. The confidential intermediary
| 20 | | shall obtain written consents from both parties that they | 21 | | wish to
disclose their identities to each other and to have | 22 | | contact with
each other.
| 23 | | (j) Oath. The confidential intermediary shall sign an oath | 24 | | of
confidentiality substantially as follows: "I, .........., | 25 | | being duly sworn, on
oath depose and say: As a condition of | 26 | | appointment as a confidential
intermediary, I affirm that:
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| 1 | | (1) I will not disclose to the petitioner,
directly or | 2 | | indirectly, any confidential information
except in a | 3 | | manner consistent with the
law.
| 4 | | (2) I recognize that violation of this oath subjects me | 5 | | to civil liability
and to a potential finding of contempt | 6 | | of court.
................................
| 7 | | SUBSCRIBED AND SWORN to before me, a Notary Public, on (insert
| 8 | | date)
| 9 | | ................................."
| 10 | | (k) Sanctions.
| 11 | | (1) Any confidential intermediary who improperly | 12 | | discloses
confidential information identifying a | 13 | | sought-after relative shall be liable to
the sought-after | 14 | | relative for damages and may also be found in contempt of
| 15 | | court.
| 16 | | (2) Any person who learns a sought-after
relative's | 17 | | identity, directly or indirectly, through the use of | 18 | | procedures
provided in this Section and who improperly | 19 | | discloses information identifying
the sought-after | 20 | | relative shall be liable to the sought-after relative for
| 21 | | actual damages plus minimum punitive damages of $10,000.
| 22 | | (3) The Department shall fine any confidential | 23 | | intermediary who improperly
discloses
confidential | 24 | | information in violation of item (1) or (2) of this | 25 | | subsection (k)
an amount up to $2,000 per improper | 26 | | disclosure. This fine does not affect
civil liability under |
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| 1 | | item (2) of this subsection (k). The Department shall
| 2 | | deposit all fines and penalties collected under this | 3 | | Section into the Illinois
Adoption Registry and Medical | 4 | | Information Fund.
| 5 | | (l) Death of person being sought. Notwithstanding any other | 6 | | provision
of this Act, if the confidential intermediary | 7 | | discovers that the person
being sought has died, he or she | 8 | | shall report this fact to the court,
along with a copy of the | 9 | | death certificate. If the sought-after relative is a birth | 10 | | parent, the confidential intermediary shall also forward a copy | 11 | | of the birth parent's death certificate, if available, to the | 12 | | Registry for inclusion in the Registry file.
| 13 | | (m) Any confidential information obtained by the | 14 | | confidential intermediary
during the course of his or her | 15 | | search shall be kept strictly confidential
and shall be used | 16 | | for the purpose of arranging contact between the
petitioner and | 17 | | the sought-after birth relative. At the time the case is
| 18 | | closed, all identifying information shall be returned to the | 19 | | court for
inclusion in the impounded adoption file.
| 20 | | (n) (Blank).
| 21 | | (o) Except as provided in subsection (k) of this Section, | 22 | | no liability shall
accrue to
the State, any State agency, any | 23 | | judge, any officer or employee of the
court, any certified | 24 | | confidential intermediary, or any agency designated
to oversee | 25 | | confidential intermediary services for acts, omissions, or
| 26 | | efforts made in good faith within the scope of this Section.
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| 1 | | (p) An adoption agency that has received a request from a | 2 | | confidential intermediary for the full name, date of birth, | 3 | | last known address, or last known telephone number of a | 4 | | sought-after relative pursuant to subsection (g) of Section | 5 | | 18.3a, or for medical information regarding a sought-after | 6 | | relative pursuant to subsection (h) of Section 18.3a, must | 7 | | satisfactorily comply with this court order within a period of | 8 | | 45 days. The court shall order the adoption agency to reimburse | 9 | | the petitioner in an amount equal to all payments made by the | 10 | | petitioner to the confidential intermediary, and the adoption | 11 | | agency shall be subject to a civil monetary penalty of $1,000 | 12 | | to be paid to the Department of Children and Family Services. | 13 | | Following the issuance of a court order finding that the | 14 | | adoption agency has not complied with Section 18.3, the | 15 | | adoption agency shall be subject to a monetary penalty of $500 | 16 | | per day for each subsequent day of non-compliance. Proceeds | 17 | | from such fines shall be utilized by the Department of Children | 18 | | and Family Services to subsidize the fees of petitioners as | 19 | | referenced in subsection (d) of this Section. | 20 | | (q) (Blank). | 21 | | Any reimbursements and fines, notwithstanding any | 22 | | reimbursement directly to the petitioner, paid under this | 23 | | subsection are in addition to other remedies a court may | 24 | | otherwise impose by law. | 25 | | The Department of Children and Family Services shall submit | 26 | | reports to the Adoption Registry-Confidential Intermediary |
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| 1 | | Advisory Council by July 1 and January 1 of each year in order | 2 | | to report the penalties assessed and collected under this | 3 | | subsection, the amounts of related deposits into the DCFS | 4 | | Children's Services Fund, and any expenditures from such | 5 | | deposits.
| 6 | | (Source: P.A. 97-110, eff. 7-14-11; 97-1063, eff. 1-1-13; | 7 | | 98-704, eff. 1-1-15 .)
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