Petition For Adoption

IN THE CIRCUIT COURT OF THE TWENTY-THIRD JUDICIAL CIRCUIT DEKALB COUNTY, ILLINOIS ____________________________________________ ____________________________________________ Petitioner(s), vs. ____________________________________________ ____________________________________________ Respondent(s). ) ) ) ) ) ) ) ) ) CASE NO.________________________________ PETITION FOR ADOPTION NOW COME(S) Petitioner(s) herein and allege as follows: (a) The full name(s) of the Petitioner(s) and, if minor(s), his/her respective age(s) is/are as follows: Name_________________________________________________________________________________ Age__________ Name_________________________________________________________________________________ Age__________ (b) The place of residence of Petitioner(s) and the length of residence in Illinois (of each) immediately preceding the filing of the within Petition is/are as follows: Place_______________________________________________________________________________ Length__________ Place_______________________________________________________________________________ Length__________ (c) The Petitioners(s) acquired/intend(s) to acquire custody of said child from _____________________________ ____________________________________whose address is__________________________________________________ ______________________________________________________on_________________________, 20_____. (d) The name, place, date of birth and sex of the child sought to be adopted is as follows:____________________ ____________________________________________________________________________________________________ . (e) The relationship, if any, of the child to each Petitioner is as follows:__________________________________ ____________________________________________________________________________________________________ (f) The names of the parents of the child, place of residence and whether minor or adult are as follows: Father ___________________________________ Age__________ Residence_____________________________________ Mother ___________________________________ Age__________ Residence_____________________________________ Neither of the parents are under any legal disability except:______________________________________________ ____________________________________________________________________________________________________ (1) The rights of the parents have been terminated by _____________________________________________, a court of competent jurisdiction. (2) The child has been surrendered to the following agency: ________________________________________ ____________________________________________________________________________________________________ Petition for Adoption/p.1 Rev. 04-01-16 American LegalNet, Inc. www.FormsWorkFlow.com (3) The parent(s), namely____________________________________________________________________ has/have been served with the notice provided in Section 12a of this Act and ________________________ __________________________________ has filed ___________________________________________ (g) The child has no living parent(s). The legal guardian of the child is __________________________________ who was appointed by _________________________________________________________________________________ (h) The child has no living parent(s) and no legal guardian is known. The name of a near relative is _________________________ Relationship____________________ Address_____________________________________ ____________________________________________________________________________________________________ (i) The name to be given the child (adult) is _______________________________________________________ (j) (1) That ______________________________________________, being the person/agency having authority to do so, has/have consented/indicated a willingness to consent to the adoption of the child by the Petitioner(s). (2) That ______________________________________________, has authority to consent to the adoption of the child by Petitioner(s), is an/are unfit person(s) for the following reason(s): ____________________________________________________________________________________________________ Orders, judgments or decrees have been entered affecting: (1) The adoption or custody of the child as follows:______________________________________________ ____________________________________________________________________________________________________ (2) The adoptive, custodial or parental rights of either Petitioner as follows, including the prior denial of any petition for adoption pertaining to such child, or to the Petitioner(s) or either of them:_______________________________________________________________________________________________ ____________________________________________________________________________________________________ (3) Additional allegation(s) required by the facts of this particular case:________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ WHEREFORE, Petitioner(s) pray(s) that the above-named _____________________________________________ may be made Respondent(s) to this Petition, and that a Summons may issue for them and each of them, returnable according to law, and that they and each of them be required to answer this petition as is by statute provided. Petitioner(s) further pray(s) that the court will, on the final hearing of this Petition, ORDER, ADJUDGE and DECREE that the said ______________________________ shall, to all legal intents and purposes, be the child of your Petitioner(s), and that the name of said child shall thereafter be _________________________________________________ ____________________________________________________________________________________________________ That this Honorable Court will make such other and further orders in the premises as may be in accordance with the law. __________________________________________ Signature of Petitioner __________________________________________ Petitioner (type or print name) _____________________________________________ Signature of Petitioner _____________________________________________ Petitioner (type or print name) (k) Petition for Adoption/p.2 Rev. 04-01-16 American LegalNet, Inc. www.FormsWorkFlow.com STAT