Illinois > Local County > Dupage > Adoption
Declaration Of Paternity With Entry Of Appearance 3217-3 - Illinois
| Declaration Of Paternity With Entry Of Appearance Form. This is a Illinois form and can be used in Adoption Dupage Local County . |
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DE CLAR ATION OF PATER NITY WITH ENTR Y OF APPE AR ANCE 3217-3 (Rev. 12/04) UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF DU PAGE IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT CASE NUM BER PLAINTIFF VS. DEFENDANT File Stamp Here DECLARATION OF PATERNITY WITH ENTRY OF APPEAR ANCE I, state as follows: 1. That I am years of age; that I reside at in the County of , State of 2. That I have been advised that is the mother of a (male) (female) child named born or expected to be born on or about and that such mother has stated that I am the father of this child. 3. I declare that I am the father of this child. 4. I understand that the mother of this child wishes to consent to the adoption of the child. I do not consent to the adoption of this child, and I understand that I must return this initial declaration of parentage form to the Clerk of the Circuit Court, DuPage County Judicial Center, 505 North County Farm Road, Wheaton, Illinois-0707 within 30 days of receipt of this notice. 5. I further understand that I am also obliged to establish my paternity pursuant to the Parentage Act of 1984, as amended, within 30 days of receiving this notice, or, if the child is not yet born, within 30 days after birth the of the child. This proceeding is separate and distinct from the above mailing of initial declaration of paternity in this second notice, I must state that I am, in fact, the father of said child, and that I intend to retain my legal rights with respect to said child, and request to be notified of any further proceedings with respect to custody or adoption of the child. 6. I hereby enter my appearance in the above entitled. OATH I have been duly sworn and I say under oath I that have read and understand this DECLARATION OF PATERNITY WITH ENTRY OF APPEARANCE. The facts it contains are true and correct to the best of my knowledge, and I understand that by signing this document I admit my paternity. I have signed this document as my free and voluntary act. Date: Signature Signed and Sworn to me this day of , 20 Notary Public-Circuit Court Clerk CHRIS KACHIROUBAS, CLERK OF THE 18TH JUDICIAL CIRCUIT COURT WHEATON, IL LINOIS 60189-0707
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