Illinois > Local County > Sangamon > Family Law > Adoption
Final And Irrevocable Consent For Adoption - Illinois
| Final And Irrevocable Consent For Adoption Form. This is a Illinois form and can be used in Adoption Family Law Sangamon Local County . |
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In The Circuit Court For The Seventh Judicial Circuit of Illinois Sangamon County, Springfield, Illinois (Petitioners) VS. } , (Relationship to child) Case Number: (Defendants) FINAL AND IRREVOCABLE CONSENT FOR ADOPTION I (Name) (Circle One) of (Name of child) , at a male/female child states: that such a child was born on (Date of Birth) (Place) and that I reside at (Address) , (City/State/Zip) County of That I am the age of years. , in the State of . That I hereby enter my appearance in this proceeding and waive service of Summons on me. 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 that such child will be placed for adoption and that I cannot under any circumstance after signing this document, change my mind and revoke or cancel this Consent or obtain or recover custody of any other rights over such child. That I have read and understand the above and I am signing in as my free and voluntary act. Date Defendant(s) Defendant(s) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com STATE OF ILLINOIS SS. County of Sangamon I, do hereby certify that a person known to me to be the same person whose name is subscribed to the foregoing Consent, appeared before me this day in person and acknowledged that he/she signed and delivered such Consent as his/her free and voluntary act for the specified purpose. I have fully explained that by signing such Consent, he/she is irrevocably relinquishing all parental rights to such child and he/she has stated that such is his/her intention or desire. In witness whereof I have here unto affixed my signature this date. Date Judge STATE OF ILLINOIS SS. County of Sangamon I, certify that: a Notary Public in and for said County, in the State aforesaid, do hereby personally known to me to be the same person whose name is subscribed to the forgoing Certificate acknowledged that he/she signed such Certificate as his/her voluntary act and that statement made in said Certificate is true. Given under my hand and Notarial Seal this date. (SEAL) Date Notary Public Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com
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