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Public Act 096-1461 | ||||
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AN ACT concerning civil law.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Adoption Act is amended by changing Section | ||||
10 as follows:
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(750 ILCS 50/10) (from Ch. 40, par. 1512)
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Sec. 10. Forms of consent and surrender; execution and
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acknowledgment thereof. A. The form of consent required for | ||||
the
adoption of a born child shall be substantially as follows:
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FINAL AND IRREVOCABLE CONSENT TO ADOPTION
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I, ...., (relationship, e.g., mother, father, relative, | ||||
guardian)
of ...., a ..male child, state:
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That such child was born on .... at ....
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That I reside at ...., County of .... and State of ....
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That I am of the age of .... years.
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That I hereby enter my appearance in this proceeding and | ||||
waive
service of summons on me.
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That I hereby acknowledge that I have been provided with a | ||||
copy of the Birth Parent Rights and Responsibilities-Private | ||||
Form before signing this Consent and that I have had time to | ||||
read, or have had read to me, this Form. I understand that if I | ||||
do not receive any of the rights as described in this Form, it | ||||
shall not constitute a basis to revoke this Final and |
Irrevocable Consent. | ||
That I do hereby consent and agree to the adoption of such | ||
child.
| ||
That I wish to and understand that by signing this consent | ||
I do
irrevocably and permanently give up all custody and other | ||
parental
rights I have to such child.
| ||
That I understand such child will be placed for adoption | ||
and that I
cannot under any circumstances, after signing this | ||
document, change my
mind and revoke or cancel this consent or | ||
obtain or recover custody or
any other rights over such child. | ||
That I have read and understand the
above and I am signing it | ||
as my free and voluntary act.
| ||
Dated (insert date).
| ||
.........................
| ||
If under Section 8 the consent of more than one person is | ||
required,
then each such person shall execute a separate | ||
consent.
| ||
A-1. (1) The form of the Final and Irrevocable Consent to | ||
Adoption by a Specified Person or Persons: Non-DCFS Case set | ||
forth in this subsection A-1 is to be used by legal parents | ||
only. This form is not to be used in cases in which there is a | ||
pending petition under Section 2-13 of the Juvenile Court Act | ||
of 1987. | ||
(2) The form of the Final and Irrevocable Consent to | ||
Adoption by a Specified Person or Persons in a non-DCFS case |
shall have the caption of the proceeding in which it is to be | ||
filed and shall be substantially as follows: | ||
FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY | ||
A SPECIFIED PERSON OR PERSONS; NON-DCFS CASE | ||
I, ...., (relationship, e.g., mother, father) of ...., a | ||
..male child, state: | ||
1. That such child was born on ...., at ....., City of ... | ||
and State of .... | ||
2. That I reside at ...., County of .... and State of .... | ||
3. That I am of the age of .... years. | ||
4. That I hereby enter my appearance in this proceeding and | ||
waive service of summons on me. | ||
5. That I hereby acknowledge that I have been provided a | ||
copy of the Birth Parent Rights and Responsibilities-Private | ||
Form before signing this Consent and that I have had time to | ||
read, or have had read to me, this Form and that I understand | ||
the Rights and Responsibilities described in this Form. I | ||
understand that if I do not receive any of my rights as | ||
described in said Form, it shall not constitute a basis to | ||
revoke this Final and Irrevocable Consent to Adoption by a | ||
Specified Person. | ||
6. That I do hereby consent and agree to the adoption of | ||
such child by .... (specified persons) only. | ||
7. That I wish to and understand that upon signing this | ||
consent I do irrevocably and permanently give up all custody | ||
and other parental rights I have to such child if such child is |
adopted by .... (specified person or persons). I hereby | ||
transfer all of my rights to the custody, care and control of | ||
such child to ............................. (specified person | ||
or persons). | ||
8. That I understand such child will be adopted by | ||
....................... (specified person or persons) and that | ||
I cannot under any circumstances, after signing this document, | ||
change my mind and revoke or cancel this consent or obtain or | ||
recover custody or any other rights over such child if | ||
............................ (specified person or persons) | ||
adopt(s) such child; PROVIDED that each specified person has | ||
filed or shall file, within 60 days from the date hereof, a | ||
petition for the adoption of such child. | ||
9. That if the specified person or persons designated | ||
herein do not file a petition for adoption within the | ||
time-frame specified above, or, if said petition for adoption | ||
is filed within the time-frame specified above but the adoption | ||
petition is dismissed with prejudice or the adoption proceeding | ||
is otherwise concluded without an order declaring the child to | ||
be the adopted child of the specified person or persons, then I | ||
understand that I will receive written notice of such | ||
circumstances within 10 business days of their occurrence. I | ||
understand that the notice will be directed to me using the | ||
contact information I have provided in this consent. I | ||
understand that I will have 10 business days from the date that | ||
the written notice is sent to me to respond, within which time |
I may request the Court to declare this consent voidable and | ||
return the child to me. I further understand that the Court | ||
will make the final decision of whether or not the child will | ||
be returned to me. If I do not make such request within 10 | ||
business days of the date of the notice, then I expressly waive | ||
any other notice or service of process in any legal proceeding | ||
for the adoption of the child. | ||
10. That I expressly acknowledge that nothing in this | ||
Consent
impairs the validity and absolute finality of this
| ||
Consent under any circumstance other than those described in
| ||
paragraph 9 of this Consent. | ||
11. That I understand that I have a remaining duty and
| ||
obligation to keep .............. (insert name and address of | ||
the attorney
for the specified person or persons) informed of | ||
my current
address or other preferred contact information until | ||
this adoption has been finalized. My failure to
do so may | ||
result in the termination of my parental rights and
the child | ||
being placed for adoption in another home. | ||
12. That I do expressly waive any other notice or service | ||
of process in any of the legal proceedings for the adoption of | ||
the child as long as the adoption proceeding by the specified | ||
person or persons is pending. | ||
13. That I have read and understand the above and I am | ||
signing it as my free and voluntary act. | ||
14. That I acknowledge that this consent is valid even if | ||
the specified person or persons separate or divorce or one of |
the specified persons dies prior to the entry of the final | ||
judgment for adoption. | ||
Dated (insert date). | ||
............................................. | ||
Signature of parent. | ||
............................................. | ||
Address of parent. | ||
............................................. | ||
Phone number(s) of parent. | ||
............................................. | ||
Personal email(s) of parent. | ||
............................................. | ||
(3) The form of the certificate of acknowledgement for a | ||
Final and Irrevocable Consent for Adoption by a Specified | ||
Person or Persons: Non-DCFS Case shall be substantially as | ||
follows: | ||
STATE OF..............)
| ||
) SS.
| ||
COUNTY OF.............) | ||
I, .................... (Name of Judge or other person), | ||
..................... (official title, name, and address), | ||
certify that ............., personally known to me to be the | ||
same person whose name is subscribed to the foregoing Final and | ||
Irrevocable Consent for Adoption by a Specified Person or | ||
Persons; non-DCFS case, appeared before me this day in person |
and acknowledged that (she)(he) signed and delivered the | ||
consent as (her)(his) free and voluntary act, for the specified | ||
purpose. I am further satisfied that, before signing this | ||
Consent, ........ has read, or has had read to him or her, the | ||
Birth Parent Rights and Responsibilities-Private Form. | ||
A-2. Birth Parent Rights and Responsibilities-Private | ||
Form. The Birth Parent Rights and Responsibilities-Private | ||
Form must be read by, or have been read to, any person | ||
executing a Final and Irrevocable Consent to Adoption under | ||
subsection A, a Final and Irrevocable Consent to Adoption by a | ||
Specified Person or Persons: Non-DCFS Case under subsection | ||
A-1, or a Consent to Adoption of Unborn Child under subsection | ||
B prior to the execution of said Consent. The form of the Birth | ||
Parent Rights and Responsibilities-Private Form shall be | ||
substantially as follows: | ||
Birth Parent Rights and Responsibilities-Private Form | ||
As a birth parent in the State of Illinois, you have the | ||
right: | ||
1. To have your own attorney represent you. The prospective | ||
adoptive parents may agree to pay for the cost of your attorney | ||
in a manner consistent with Illinois law, but they are not | ||
required to do so. | ||
2. To be treated with dignity and respect at all times and | ||
to make decisions free from coercion and pressure. | ||
3. To receive counseling before and after signing a Final | ||
and Irrevocable Consent to Adoption ("Consent"), a Final and |
Irrevocable Consent to Adoption by a Specified Person or | ||
Persons: Non-DCFS Case ("Specified Consent"), or a Consent to | ||
Adoption of Unborn Child ("Unborn Consent"). The prospective | ||
adoptive parents may agree to pay for the cost of counseling in | ||
a manner consistent with Illinois law, but they are not | ||
required to do so. | ||
4. To ask to be involved in choosing your child's | ||
prospective adoptive parents and to ask to meet them. | ||
5. To ask your child's prospective adoptive parents any | ||
questions that pertain to your decision to place your child | ||
with them. | ||
6. To see your child before signing a Consent or Specified | ||
Consent. | ||
7. To request contact with your child and/or the child's | ||
prospective adoptive parents, with the understanding that any | ||
promises regarding contact with your child or receipt of | ||
information about the child after signing a Consent, Specified | ||
Consent, or Unborn Consent cannot be enforced under Illinois | ||
law. | ||
8. To receive copies of all documents that you sign and | ||
have those documents provided to you in your preferred | ||
language. | ||
9. To request that your identifying information remain | ||
confidential, unless required otherwise by Illinois law or | ||
court order, and to register with the Illinois Adoption | ||
Registry and Medical Information Exchange. |
10. To work with an adoption agency or attorney of your | ||
choice, or change said agency or attorney, provided you | ||
promptly inform all of the parties currently involved. | ||
11. To receive, upon request, a written list of any | ||
promised support, financial or otherwise, from your attorney or | ||
the attorney for your child's prospective adoptive parents. | ||
12. To delay signing a Consent, Specified Consent, or | ||
Unborn Consent if you are not ready to do so. | ||
13. To decline to sign a Consent, Specified Consent, or | ||
Unborn Consent even if you have received financial support from | ||
the prospective adoptive parents. | ||
If you do not receive any of the rights described in this | ||
Form, it shall not be a basis to revoke a Consent, Specified | ||
Consent, or Unborn Consent. | ||
As a Birth Parent in the State of Illinois, you have the | ||
responsibility: | ||
1. To carefully consider your reasons for choosing | ||
adoption. | ||
2. To voluntarily provide all known medical, background, | ||
and family information about yourself and your immediate family | ||
to your child's prospective adoptive parents or their attorney. | ||
For the health of your child, you are strongly encouraged, but | ||
not required, to provide all known medical, background, and | ||
family history information about yourself and your family to | ||
your child's prospective adoptive parents or their attorney. | ||
3. (Birth mothers only) To accurately complete an Affidavit |
of Identification, which identifies the father of the child | ||
when known, with the understanding that a birth mother has a | ||
right to decline to identify the birth father. | ||
4. To not accept financial support or reimbursement of | ||
pregnancy related expenses simultaneously from more than one | ||
source. | ||
B. The form of consent required for the adoption of an | ||
unborn child
shall be substantially as follows:
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CONSENT TO ADOPTION OF UNBORN CHILD
| ||
I, ...., state:
| ||
That I am the father of a child expected to be born on or | ||
about ....
to .... (name of mother).
| ||
That I reside at .... County of ...., and State of .....
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That I am of the age of .... years.
| ||
That I hereby enter my appearance in such adoption | ||
proceeding and
waive service of summons on me.
| ||
That I hereby acknowledge that I have been provided with a | ||
copy of the Birth Parent Rights and Responsibilities-Private | ||
Form before signing this Consent, and that I have had time to | ||
read, or have had read to me, this Form. I understand that if I | ||
do not receive any of the rights as described in this Form, it | ||
shall not constitute a basis to revoke this Consent to Adoption | ||
of Unborn Child. | ||
That I do hereby consent and agree to the adoption of such | ||
child, and
that I have not previously executed a consent or | ||
surrender with respect
to such child.
|
That I wish to and do understand that by signing this | ||
consent I do
irrevocably and permanently give up all custody | ||
and other parental
rights I have to such child, except that I | ||
have the right to revoke this
consent by giving written notice | ||
of my revocation not later than 72
hours after the birth of the | ||
child.
| ||
That I understand such child will be placed for adoption | ||
and that,
except as hereinabove provided, I cannot under any | ||
circumstances, after
signing this document, change my mind and | ||
revoke or cancel this consent
or obtain or recover custody or | ||
any other rights over such child.
| ||
That I have read and understand the above and I am signing | ||
it as my
free and voluntary act.
| ||
Dated (insert date).
| ||
........................
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B-5. (1) The parent of a child may execute a consent to | ||
standby
adoption by a specified person or persons. A consent | ||
under this subsection B-5
shall be acknowledged by a parent | ||
pursuant to subsection H and subsection K of
this Section.
The | ||
form of consent required for the standby adoption of a born | ||
child
effective at a future date when the consenting
parent of | ||
the child dies or
requests that a final judgment of adoption be | ||
entered shall be substantially as
follows:
| ||
FINAL AND IRREVOCABLE CONSENT
| ||
TO STANDBY ADOPTION
| ||
I, ..., (relationship, e.g. mother or father)
of ...., a |
..male child, state:
| ||
That the child was born on .... at .....
| ||
That I reside at ...., County of ...., and State of .....
| ||
That I am of the age of .... years.
| ||
That I hereby enter my appearance in this proceeding and | ||
waive service of
summons on me in this action only.
| ||
That I do hereby consent and
agree to the standby adoption | ||
of the child, and that I have not previously
executed a consent | ||
or surrender with respect to the child.
| ||
That I wish to and understand that by signing this consent | ||
I do irrevocably
and permanently give up all custody and other | ||
parental rights I have to the
child, effective upon
(my death) | ||
(the child's other parent's death) or upon (my) (the other
| ||
parent's) request for the entry of a final judgment for | ||
adoption if .....
(specified person or persons) adopt my child.
| ||
That I understand that until (I die) (the child's other | ||
parent dies), I
retain all legal rights and obligations | ||
concerning the child, but at that time,
I irrevocably give all | ||
custody and other parental rights to .... (specified
person or | ||
persons).
| ||
I understand my child will be adopted by ....... (specified | ||
person or
persons) only and that I cannot, under any | ||
circumstances, after signing this
document, change my mind and | ||
revoke or cancel this consent or obtain or recover
custody or | ||
any other rights over my child if ..... (specified person or
| ||
persons) adopt my child.
|
I understand that this consent to standby adoption is valid | ||
only if the
petition for standby adoption is filed and that if | ||
....... (specified person or
persons), for any reason, cannot | ||
or will not file a petition for standby
adoption or if his, | ||
her, or their petition for standby adoption is denied, then
| ||
this consent is void. I have the right to notice of any other | ||
proceeding that
could affect my parental rights.
| ||
That I have read and understand the above and I am signing | ||
it as my free and
voluntary act.
| ||
Dated (insert date).
| ||
....................
| ||
If under Section 8 the consent of more than one person is | ||
required, then each
such
person shall execute a separate | ||
consent. A separate consent shall be executed
for each
child.
| ||
(2) If the parent consents to a standby adoption by 2 | ||
specified persons,
then the form shall contain 2 additional | ||
paragraphs in substantially the
following form:
| ||
If .... (specified persons) obtain a judgment of
| ||
dissolution of
marriage before the judgment for adoption is | ||
entered, then .....
(specified person) shall adopt my child. I | ||
understand that I cannot change my
mind and revoke this consent | ||
or obtain or recover custody of my child if .....
(specified | ||
persons) obtain a judgment of dissolution of marriage and .....
| ||
(specified person) adopts my child. I understand that I cannot | ||
change my
mind and revoke this consent if ...... (specified |
persons) obtain a
judgment of dissolution of marriage before | ||
the adoption is final. I
understand that this consent to | ||
adoption has no effect on who will get custody
of my child if | ||
..... (specified persons) obtain a judgment of dissolution
of | ||
marriage after the adoption is final. I understand that if | ||
either .....
(specified persons) dies before the petition to | ||
adopt my child is granted, then
the surviving person may adopt | ||
my child. I understand that I cannot change my
mind and revoke | ||
this consent or obtain or recover custody of my child if the
| ||
surviving person adopts my child.
| ||
A consent to standby adoption by specified persons on this | ||
form shall have no
effect on a court's determination of custody | ||
or visitation under the Illinois
Marriage and Dissolution
of | ||
Marriage Act if the marriage of the specified persons is | ||
dissolved before
the adoption is final.
| ||
(3) The form of the certificate of acknowledgement for a | ||
Final and
Irrevocable Consent for Standby Adoption shall be | ||
substantially as follows:
| ||
STATE OF .....)
| ||
) SS.
| ||
COUNTY OF ....)
| ||
I, ....... (name of Judge or other person) ..... (official | ||
title,
name, and address), certify that ......., personally | ||
known to me to be
the same person whose name is subscribed to |
the foregoing Final and Irrevocable
Consent to Standby | ||
Adoption, appeared before me this day in person and
| ||
acknowledged that (she) (he) signed and
delivered the consent | ||
as (her) (his) free and voluntary act, for the specified
| ||
purpose.
| ||
I have fully explained that this consent to adoption is | ||
valid only if the
petition to adopt is filed, and that if the | ||
specified person or persons, for
any reason, cannot or will not | ||
adopt the child or if the adoption petition is
denied, then | ||
this consent will be void. I have fully explained that if the
| ||
specified person or persons adopt the child, by signing this | ||
consent (she) (he)
is irrevocably and permanently | ||
relinquishing all parental rights to the child,
and (she) (he) | ||
has stated that such is (her) (his) intention and desire.
| ||
Dated (insert date).
| ||
Signature..............................
| ||
(4) If a consent to standby adoption is executed in this | ||
form,
the consent shall be valid only if the specified
person | ||
or persons adopt the child. The consent shall be void if:
| ||
(a) the specified person or persons do not file a petition | ||
for standby
adoption of the child; or
| ||
(b) a court denies the standby adoption petition.
| ||
The parent shall not need to take further action to revoke | ||
the consent if the
standby adoption by the specified person or | ||
persons does not occur,
notwithstanding the provisions of | ||
Section 11 of this Act.
|
C. The form of surrender to any agency given by a parent of | ||
a born
child who is to be subsequently placed for adoption | ||
shall be
substantially as follows and shall contain such other | ||
facts and
statements as the particular agency shall require.
| ||
FINAL AND IRREVOCABLE SURRENDER
| ||
FOR PURPOSES OF ADOPTION
| ||
I, .... (relationship, e.g., mother, father, relative, | ||
guardian) of
...., a ..male child, state:
| ||
That such child was born on ...., at .....
| ||
That I reside at ...., County of ...., and State of .....
| ||
That I am of the age of .... years.
| ||
That I do hereby surrender and entrust the entire custody | ||
and control
of such child to the .... (the "Agency"), a | ||
(public) (licensed) child
welfare agency with its principal | ||
office in the City of ...., County of
.... and State of ...., | ||
for the purpose of enabling it to care for and
supervise the | ||
care of such child, to place such child for adoption and
to | ||
consent to the legal adoption of such child.
| ||
That I hereby grant to the Agency full power and authority | ||
to place
such child with any person or persons it may in its | ||
sole discretion
select to become the adopting parent or parents | ||
and to consent to the
legal adoption of such child by such | ||
person or persons; and to take any
and all measures which, in | ||
the judgment of the Agency, may be for the
best interests of | ||
such child, including authorizing medical, surgical
and dental | ||
care and treatment including inoculation and anaesthesia for
|
such child.
| ||
That I wish to and understand that by signing this | ||
surrender I do
irrevocably and permanently give up all custody | ||
and other parental
rights I have to such child.
| ||
That I understand I cannot under any circumstances, after | ||
signing
this surrender, change my mind and revoke or cancel | ||
this surrender or
obtain or recover custody or any other rights | ||
over such child.
| ||
That I have read and understand the above and I am signing | ||
it as my
free and voluntary act.
| ||
Dated (insert date).
| ||
........................
| ||
C-5. The form of a Final and Irrevocable Designated | ||
Surrender for Purposes of Adoption to any agency given by a | ||
parent of a born child who is to be subsequently placed for | ||
adoption shall be substantially as follows and shall contain | ||
such other facts and statements as the particular agency shall | ||
require: | ||
FINAL AND IRREVOCABLE DESIGNATED SURRENDER | ||
FOR PURPOSES OF ADOPTION | ||
I, .... (relationship, e.g., mother, father, relative, | ||
guardian) of ...., a ..male child, state: | ||
1. That such child was born on ...., at ..... | ||
2. That I reside at ...., County of ...., and State of | ||
..... | ||
3. That I am of the age of .... years. |
4. That I do hereby surrender and entrust the entire | ||
custody and control of such child to the .... (the "Agency"), a | ||
(public) (licensed) child welfare agency with its principal | ||
office in the City of ...., County of .... and State of ...., | ||
for the purpose of enabling it to care for and supervise the | ||
care of such child, to place such child for adoption with | ||
............................. (specified person or persons) | ||
and to consent to the legal adoption of such child and to take | ||
any and all measures which, in the judgment of the Agency, may | ||
be for the best interests of such child, including authorizing | ||
medical, surgical and dental care and treatment including | ||
inoculation and anesthesia for such child. | ||
5. That I wish to and understand that by signing this | ||
surrender I do irrevocably and permanently give up all custody | ||
and other parental rights I have to such child. | ||
6. That if the petition for adoption is not filed by the
| ||
specified person or persons designated herein or, if the
| ||
petition for adoption is filed but the adoption petition is
| ||
dismissed with prejudice or the adoption proceeding is
| ||
otherwise concluded without an order declaring the child to be
| ||
the adopted child of each specified person, then I understand | ||
that the Agency will provide notice to me within 10 business | ||
days and that such notice will be directed to me using the | ||
contact information I have provided to the Agency. I understand | ||
that I will have 10 business days from the date that the Agency | ||
sends me its notice to respond, within which time I may choose |
to designate other adoptive parent(s). However, I acknowledge | ||
that
the Agency has full power and authority to place the child | ||
for adoption with
any person or persons it may in its sole | ||
discretion select to
become the adopting parent or parents and | ||
to consent to the
legal adoption of the child by such person or | ||
persons. | ||
7. That I acknowledge that this surrender is valid even if | ||
the specified persons separate or divorce or one of the | ||
specified persons dies prior to the entry of the final judgment | ||
for adoption. | ||
8. That I expressly acknowledge that the above paragraphs 6 | ||
and 7 do not impair the validity and absolute finality of this | ||
surrender under any circumstance. | ||
9. That I understand that I have a remaining obligation to | ||
keep the Agency informed of my current contact information | ||
until the adoption of the child has been finalized if I wish to | ||
be notified in the event the adoption by the specified | ||
person(s) cannot proceed. | ||
10. That I understand I cannot under any circumstances, | ||
after signing this surrender, change my mind and revoke or | ||
cancel this surrender or obtain or recover custody or any other | ||
rights over such child. | ||
11. That I have read and understand the above and I am | ||
signing it as my free and voluntary act. | ||
Dated (insert date). | ||
.............................. |
D. The form of surrender to an agency given by a parent of | ||
an unborn
child who is to be subsequently placed for adoption | ||
shall be
substantially as follows and shall contain such other | ||
facts and
statements as the particular agency shall require.
| ||
SURRENDER OF UNBORN CHILD FOR
| ||
PURPOSES OF ADOPTION
| ||
I, .... (father), state:
| ||
That I am the father of a child expected to be born on or | ||
about ....
to .... (name of mother).
| ||
That I reside at ...., County of ...., and State of .....
| ||
That I am of the age of .... years.
| ||
That I do hereby surrender and entrust the entire custody | ||
and control
of such child to the .... (the "Agency"), a | ||
(public) (licensed) child
welfare agency with its principal | ||
office in the City of ...., County of
.... and State of ...., | ||
for the purpose of enabling it to care for and
supervise the | ||
care of such child, to place such child for adoption and
to | ||
consent to the legal adoption of such child, and that I have | ||
not
previously executed a consent or surrender with respect to | ||
such child.
| ||
That I hereby grant to the Agency full power and authority | ||
to place
such child with any person or persons it may in its | ||
sole discretion
select to become the adopting parent or parents | ||
and to consent to the
legal adoption of such child by such | ||
person or persons; and to take any
and all measures which, in | ||
the judgment of the Agency, may be for the
best interests of |
such child, including authorizing medical, surgical
and dental | ||
care and treatment, including inoculation and anaesthesia for
| ||
such child.
| ||
That I wish to and understand that by signing this | ||
surrender I do
irrevocably and permanently give up all custody | ||
and other parental
rights I have to such child.
| ||
That I understand I cannot under any circumstances, after | ||
signing
this surrender, change my mind and revoke or cancel | ||
this surrender or
obtain or recover custody or any other rights | ||
over such child, except
that I have the right to revoke this | ||
surrender by giving written notice
of my revocation not later | ||
than 72 hours after the birth of such child.
| ||
That I have read and understand the above and I am signing | ||
it as my
free and voluntary act.
| ||
Dated (insert date).
| ||
........................
| ||
E. The form of consent required from the parents for the | ||
adoption of
an adult, when such adult elects to obtain such | ||
consent, shall be
substantially as follows:
| ||
CONSENT
| ||
I, ...., (father) (mother) of ...., an adult, state:
| ||
That I reside at ...., County of .... and State of .....
| ||
That I do hereby consent and agree to the adoption of such | ||
adult by
.... and .....
| ||
Dated (insert date).
| ||
.........................
|
F. The form of consent required for the adoption of a child | ||
of the
age of 14 years or upwards, or of an adult, to be given | ||
by such person,
shall be substantially as follows:
| ||
CONSENT
| ||
I, ...., state:
| ||
That I reside at ...., County of .... and State of ..... | ||
That I am
of the age of .... years. That I consent and agree to | ||
my adoption by
.... and .....
| ||
Dated (insert date).
| ||
........................
| ||
G. The form of consent given by an agency to the adoption | ||
by
specified persons of a child previously surrendered to it | ||
shall set
forth that the agency has the authority to execute | ||
such consent. The
form of consent given by a guardian of the | ||
person of a child sought to
be adopted, appointed by a court of | ||
competent jurisdiction, shall set
forth the facts of such | ||
appointment and the authority of the guardian to
execute such | ||
consent.
| ||
H. A consent (other than that given by an agency, or | ||
guardian of the
person of the child sought to be adopted who | ||
was appointed by a court of
competent jurisdiction) shall be | ||
acknowledged by a parent before a judge of a court of competent | ||
jurisdiction or, except as otherwise provided in
this Act, | ||
before a representative of an agency, or before a person, other | ||
than the attorney for the prospective adoptive parent or | ||
parents, designated by a court of competent
jurisdiction.
|
I. A surrender, or any other document equivalent to a | ||
surrender, by
which a child is surrendered to an agency shall | ||
be acknowledged by the
person signing such surrender, or other | ||
document, before a judge of a court of competent jurisdiction, | ||
or, except as otherwise provided in this Act, before a | ||
representative of an agency, or before a person designated by a | ||
court
of competent jurisdiction.
| ||
J. The form of the certificate of acknowledgment for a | ||
consent, a
surrender, or any other document equivalent to a | ||
surrender, shall be
substantially as follows:
| ||
STATE OF ....)
| ||
) SS.
| ||
COUNTY OF ...)
| ||
I, .... (Name of judge or other person), .... (official | ||
title, name and
location of court or status or position of | ||
other person),
certify that ...., personally known to me to be | ||
the same person whose
name is subscribed to the foregoing | ||
(consent) (surrender), appeared
before me this day in person | ||
and acknowledged that (she) (he) signed and
delivered such | ||
(consent) (surrender) as (her) (his) free and voluntary
act, | ||
for the specified purpose.
| ||
I have fully explained that by signing such (consent) | ||
(surrender)
(she) (he) is irrevocably relinquishing all | ||
parental rights to such
child or adult and (she) (he) has | ||
stated that such is (her) (his)
intention and desire. (Add if | ||
Consent only) I am further satisfied that, before signing this |
Consent, ........ has read, or has had read to him or her, the | ||
Birth Parent Rights and Responsibilities-Private Form.
| ||
Dated (insert date).
| ||
Signature ...............
| ||
K. When the execution of a consent or a surrender is | ||
acknowledged
before someone other than a judge,
such other | ||
person shall have his or her signature on the certificate
| ||
acknowledged before a notary public, in form substantially as | ||
follows:
| ||
STATE OF ....)
| ||
) SS.
| ||
COUNTY OF ...)
| ||
I, a Notary Public, in and for the County of ......, in the | ||
State of
......, certify that ...., personally known to me to | ||
be the
same person whose name is subscribed to the foregoing | ||
certificate of
acknowledgment, appeared before me in person and | ||
acknowledged that (she)
(he) signed such certificate as (her) | ||
(his) free and voluntary act and
that the statements made in | ||
the certificate are true.
| ||
Dated (insert date).
| ||
Signature ...................... Notary Public
| ||
(official seal)
| ||
There shall be attached a certificate of magistracy, or | ||
other
comparable proof of office of the notary public | ||
satisfactory to the
court, to a consent signed and acknowledged |
in another state.
| ||
L. A surrender or consent executed and acknowledged outside | ||
of this
State, either in accordance with the law of this State | ||
or in accordance
with the law of the place where executed, is | ||
valid.
| ||
M. Where a consent or a surrender is signed in a foreign | ||
country,
the execution of such consent shall be acknowledged or | ||
affirmed in a
manner conformable to the law and procedure of | ||
such country.
| ||
N. If the person signing a consent or surrender is in the | ||
military
service of the United States, the execution of such | ||
consent or surrender
may be acknowledged before a commissioned | ||
officer and the signature of
such officer on such certificate | ||
shall be verified or acknowledged
before a notary public or by | ||
such other procedure as is then in effect
for such division or | ||
branch of the armed forces.
| ||
O. (1) The parent or parents of a child in whose interests | ||
a petition
under Section 2-13 of the Juvenile Court Act of 1987 | ||
is pending may, with the
approval of the designated | ||
representative of the Department of Children and
Family | ||
Services, execute a consent to adoption by a specified person | ||
or
persons:
| ||
(a) in whose physical custody the child has resided for | ||
at least 6
months;
or
| ||
(b) in whose physical custody at least one sibling of | ||
the child who is the
subject of this consent has resided |
for at least 6 months, and
the child who is
the subject of | ||
this consent is currently residing in this foster home; or
| ||
(c) in whose physical custody a child under one year of | ||
age has resided
for at least 3 months.
| ||
A consent under this subsection O shall be acknowledged by a | ||
parent pursuant to
subsection H and subsection K of this | ||
Section.
| ||
(2) The consent to adoption by a specified person or | ||
persons shall have the
caption of the proceeding in which it is | ||
to be filed and shall be substantially
as follows:
| ||
FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY
| ||
A SPECIFIED PERSON OR PERSONS : DCFS CASE
| ||
I, ......................................, the | ||
.................. (mother or
father) of a ....male child, | ||
state:
| ||
1. My child ............................ (name of | ||
child) was born on
(insert date) at .................... | ||
Hospital in
................ County, State of | ||
...............
| ||
2. I reside at ......................, County of | ||
............. and
State of ..............
| ||
3. I, ..........................., am .... years old.
| ||
4. I enter my appearance in this action to adopt my | ||
child by the
person or persons specified herein by me and | ||
waive service of
summons on me in this action only.
| ||
5. I consent to the adoption of my child by
|
.............................
(specified person or | ||
persons) only.
| ||
6. I wish to sign this consent and I understand that by | ||
signing this
consent I irrevocably and permanently give up | ||
all parental rights I have to my
child if my child is | ||
adopted by ............................. (specified person
| ||
or persons).
| ||
7. I understand my child will be adopted by | ||
.............................
(specified person or | ||
persons) only and that I cannot under any circumstances,
| ||
after signing this document, change my mind and revoke or | ||
cancel this consent
or obtain or recover custody or any | ||
other rights over my child if
............................ | ||
(specified person or persons) adopt my child.
| ||
8. I understand that this consent to adoption is valid | ||
only if the
petition to adopt is filed within one year from | ||
the date that I sign it and
that if ....................... | ||
(specified person or persons), for any reason,
cannot or | ||
will not file a petition to adopt my child within that one | ||
year
period or if their adoption petition is denied, then | ||
this consent will be
voidable after one year upon the | ||
timely filing of my motion. If I file this
motion before | ||
the filing of the petition for adoption, I understand that | ||
the
court shall revoke this specific consent.
I have the | ||
right to notice of any other proceeding that could affect | ||
my
parental rights, except for the proceeding for |
............. (specified person
or persons) to adopt my | ||
child.
| ||
9. I have read and understand the above and I am | ||
signing it as my free
and voluntary act.
| ||
Dated (insert date).
| ||
.............................................
| ||
Signature of parent
| ||
(3) If the parent consents to an adoption by 2 specified | ||
persons, then the
form shall contain 2 additional paragraphs in | ||
substantially the following form:
| ||
10. If ............... (specified persons) get a | ||
divorce
before the petition to adopt my child is granted, | ||
then ..........
(specified person) shall adopt my child. I | ||
understand that I
cannot change my mind and revoke this | ||
consent or obtain or
recover custody over my child if | ||
............. (specified persons)
divorce and | ||
............. (specified person) adopts my
child. I | ||
understand that I cannot change my mind and revoke
this | ||
consent or obtain or recover custody over my child if
| ||
................. (specified persons) divorce after the
| ||
adoption is final. I understand that this consent to | ||
adoption
has no effect on who will get custody of my child | ||
if they
divorce after the adoption is final.
| ||
11. I understand that if either ...............
| ||
(specified persons) dies before the petition to adopt
my | ||
child is granted, then the surviving person can adopt my |
child. I
understand that I cannot change my mind and revoke | ||
this consent
or obtain or recover custody over my child if | ||
the surviving
person adopts my child.
| ||
A consent to adoption by specified persons on this form | ||
shall
have no effect on a court's determination of custody or | ||
visitation
under the Illinois Marriage and Dissolution of | ||
Marriage Act if the
marriage of the
specified persons is | ||
dissolved after the adoption is final.
| ||
(4) The form of the certificate of acknowledgement for a | ||
Final and
Irrevocable Consent for Adoption by a Specified | ||
Person or Persons : DCFS Case shall be
substantially as follows:
| ||
STATE OF..............)
| ||
) SS.
| ||
COUNTY OF.............)
| ||
I, .................... (Name of Judge or other person),
| ||
..................... (official title, name, and address),
| ||
certify that ............., personally known to me to be the | ||
same person whose
name is subscribed to the foregoing Final and | ||
Irrevocable Consent for Adoption
by a Specified Person or | ||
Persons, appeared before me this day
in person and acknowledged | ||
that (she)(he) signed and delivered the consent as
(her)(his) | ||
free and voluntary act, for the specified purpose.
| ||
I have fully explained that this consent to adoption is | ||
valid only if the
petition to adopt is filed within one year |
from the date that it is signed, and
that if the specified | ||
person or persons, for any reason, cannot or will not
adopt the | ||
child or if the adoption petition is denied, then this consent | ||
will
be voidable after one year upon the timely filing of a | ||
motion by the parent
to revoke the consent. I explained that if | ||
this motion is filed before the
filing of the petition for | ||
adoption, the court shall revoke this specific
consent. I have | ||
fully explained that if the specified person or
persons adopt
| ||
the child, by signing this consent this parent is irrevocably
| ||
and permanently
relinquishing all parental rights to the child, | ||
and this parent has stated that
such is (her)(his) intention | ||
and desire.
| ||
Dated (insert date).
| ||
...............................
| ||
Signature
| ||
(5) If a consent to adoption by a specified person or | ||
persons is executed in
this form, the following provisions | ||
shall apply. The consent shall be valid
only if that specified | ||
person or persons adopt the child. The consent shall be
| ||
voidable after one year if:
| ||
(a) the specified person or persons do not file a | ||
petition to adopt the
child within one year after the | ||
consent is signed and the parent files a
timely motion to | ||
revoke this consent. If this motion is filed before the
| ||
filing of the petition for adoption the court shall revoke | ||
this consent; or
|
(b) a court denies the adoption petition; or
| ||
(c) the Department of Children and Family Services | ||
Guardianship
Administrator determines that the specified | ||
person or persons will not or
cannot complete the adoption, | ||
or in the best interests of the child should not
adopt the | ||
child.
| ||
Within 30 days of the consent becoming void, the Department | ||
of Children and
Family Services Guardianship Administrator | ||
shall make good faith attempts to
notify the parent in writing | ||
and shall give written notice to the court and all
additional | ||
parties in writing that the adoption has not occurred or will | ||
not
occur and that the consent is void. If the adoption by a | ||
specified person or
persons does not occur, no proceeding for | ||
termination of parental rights shall
be brought unless the | ||
biological parent who executed the consent to adoption by
a | ||
specified person or persons has been notified of the proceeding | ||
pursuant to
Section 7 of this Act or subsection (4) of Section | ||
2-13 of the Juvenile Court
Act of 1987. The parent shall not | ||
need to take further action to revoke the
consent if the | ||
specified adoption does not occur, notwithstanding the
| ||
provisions of Section 11 of this Act.
| ||
(6) The Department of Children and Family Services is | ||
authorized
to promulgate rules necessary to implement this | ||
subsection O.
| ||
(7) The Department shall collect and maintain data | ||
concerning the efficacy
of specific consents. This data shall |
include the number of specific consents
executed and their | ||
outcomes, including but not limited to the number of
children | ||
adopted pursuant to the consents, the number of children for | ||
whom
adoptions are not completed, and the reason or reasons why | ||
the adoptions are
not completed.
| ||
P. If the person signing a consent is incarcerated or | ||
detained in a correctional facility, prison, jail, detention | ||
center, or other comparable institution, either in this State | ||
or any other jurisdiction, the execution of such consent may be | ||
acknowledged before social service personnel of such | ||
institution, or before a person designated by a court of | ||
competent jurisdiction. | ||
Q. A consent may be acknowledged telephonically, via | ||
audiovisual connection, or other electronic means, provided | ||
that a court of competent jurisdiction has entered an order | ||
approving the execution of the consent in such manner and has | ||
designated an individual to be physically present with the | ||
parent executing such consent in order to verify the identity | ||
of the parent. | ||
R. An agency whose representative is acknowledging a | ||
consent pursuant to this Section shall be a public child | ||
welfare agency, or a child welfare agency, or a child placing | ||
agency that is authorized or licensed in the State or | ||
jurisdiction in which the consent is signed. | ||
(Source: P.A. 96-601, eff. 8-21-09.)
| ||
Section 99. Effective date. This Act takes effect January |
1, 2011. |