Illinois 2023-2024 Regular Session

Illinois House Bill HB3101 Compare Versions

Only one version of the bill is available at this time.

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1	1	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3101 Introduced , by Rep. Jennifer Gong-Gershowitz SYNOPSIS AS INTRODUCED: See Index Amends the Abandoned Newborn Infant Protection Act. Provides that there is a presumption that by relinquishing a newborn infant in accordance with the Act, the infant's parent waives notice of any legal proceeding to terminate his or her parental rights. Requires a hospital to complete and submit, on behalf of a relinquished newborn infant, an application for medical assistance benefits provided under the Illinois Public Aid Code and to provide all available medical information and records regarding the infant to the Department of Children and Family Services and to the child welfare agency (rather than child-placing agency) that has accepted the referral of the infant. Provides that if the person (rather than parent) who relinquished a newborn infant, or a person claiming to be the parent of the infant, returns to reclaim the infant within 30 days (rather than 72 hours) after the infant was relinquished to a police station, the police station must inform such person of the name and location of the hospital to which the infant was transported. Makes changes to provisions concerning information for a relinquishing person on the relinquishment process; a child welfare agency's authority to make medical and health related decisions for a relinquished infant; notice to the infant's biological parents of legal proceedings to terminate their parental rights; the appointment of a guardian ad litem to represent the infant's interests; the alternative to relinquishment that results in the adoption of a relinquished infant under 30 (rather than 7) days of age; and other matters. Amends the Abandoned Newborn Infant Protection Act, the Immunization Data Registry Act, the Illinois Parentage Act of 2015, and the Adoption Act by replacing all references to "child placing agency" with "child welfare agency". LRB103 29344 KTG 55731 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3101 Introduced , by Rep. Jennifer Gong-Gershowitz SYNOPSIS AS INTRODUCED: See Index See Index Amends the Abandoned Newborn Infant Protection Act. Provides that there is a presumption that by relinquishing a newborn infant in accordance with the Act, the infant's parent waives notice of any legal proceeding to terminate his or her parental rights. Requires a hospital to complete and submit, on behalf of a relinquished newborn infant, an application for medical assistance benefits provided under the Illinois Public Aid Code and to provide all available medical information and records regarding the infant to the Department of Children and Family Services and to the child welfare agency (rather than child-placing agency) that has accepted the referral of the infant. Provides that if the person (rather than parent) who relinquished a newborn infant, or a person claiming to be the parent of the infant, returns to reclaim the infant within 30 days (rather than 72 hours) after the infant was relinquished to a police station, the police station must inform such person of the name and location of the hospital to which the infant was transported. Makes changes to provisions concerning information for a relinquishing person on the relinquishment process; a child welfare agency's authority to make medical and health related decisions for a relinquished infant; notice to the infant's biological parents of legal proceedings to terminate their parental rights; the appointment of a guardian ad litem to represent the infant's interests; the alternative to relinquishment that results in the adoption of a relinquished infant under 30 (rather than 7) days of age; and other matters. Amends the Abandoned Newborn Infant Protection Act, the Immunization Data Registry Act, the Illinois Parentage Act of 2015, and the Adoption Act by replacing all references to "child placing agency" with "child welfare agency". LRB103 29344 KTG 55731 b LRB103 29344 KTG 55731 b A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3101 Introduced , by Rep. Jennifer Gong-Gershowitz SYNOPSIS AS INTRODUCED:
3	3	See Index See Index
4	4	See Index
5	5	Amends the Abandoned Newborn Infant Protection Act. Provides that there is a presumption that by relinquishing a newborn infant in accordance with the Act, the infant's parent waives notice of any legal proceeding to terminate his or her parental rights. Requires a hospital to complete and submit, on behalf of a relinquished newborn infant, an application for medical assistance benefits provided under the Illinois Public Aid Code and to provide all available medical information and records regarding the infant to the Department of Children and Family Services and to the child welfare agency (rather than child-placing agency) that has accepted the referral of the infant. Provides that if the person (rather than parent) who relinquished a newborn infant, or a person claiming to be the parent of the infant, returns to reclaim the infant within 30 days (rather than 72 hours) after the infant was relinquished to a police station, the police station must inform such person of the name and location of the hospital to which the infant was transported. Makes changes to provisions concerning information for a relinquishing person on the relinquishment process; a child welfare agency's authority to make medical and health related decisions for a relinquished infant; notice to the infant's biological parents of legal proceedings to terminate their parental rights; the appointment of a guardian ad litem to represent the infant's interests; the alternative to relinquishment that results in the adoption of a relinquished infant under 30 (rather than 7) days of age; and other matters. Amends the Abandoned Newborn Infant Protection Act, the Immunization Data Registry Act, the Illinois Parentage Act of 2015, and the Adoption Act by replacing all references to "child placing agency" with "child welfare agency".
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11	11	1 AN ACT concerning children.
12	12	2 Be it enacted by the People of the State of Illinois,
13	13	3 represented in the General Assembly:
14	14	4 Section 5. The Abandoned Newborn Infant Protection Act is
15	15	5 amended by changing Sections 10, 15, 20, 22, 30, 35, 37, 40,
16	16	6 50, 55, 60, and 65, as follows:
17	17	7 (325 ILCS 2/10)
18	18	8 Sec. 10. Definitions. In this Act:
19	19	9 "Abandon" has the same meaning as in the Abused and
20	20	10 Neglected Child Reporting Act.
21	21	11 "Abused child" has the same meaning as in the Abused and
22	22	12 Neglected Child Reporting Act.
23	23	13 "Child welfare Child-placing agency" means an Illinois a
24	24	14 licensed public or private agency that receives a child for
25	25	15 the purpose of placing or arranging for the placement of the
26	26	16 child in a foster or pre-adoptive family home or other
27	27	17 facility for child care, apart from the custody of the child's
28	28	18 parents.
29	29	19 "Department" or "DCFS" means the Illinois Department of
30	30	20 Children and Family Services.
31	31	21 "Emergency medical facility" means a freestanding
32	32	22 emergency center or trauma center, as defined in the Emergency
33	33	23 Medical Services (EMS) Systems Act.
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37	37	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3101 Introduced , by Rep. Jennifer Gong-Gershowitz SYNOPSIS AS INTRODUCED:
38	38	See Index See Index
39	39	See Index
40	40	Amends the Abandoned Newborn Infant Protection Act. Provides that there is a presumption that by relinquishing a newborn infant in accordance with the Act, the infant's parent waives notice of any legal proceeding to terminate his or her parental rights. Requires a hospital to complete and submit, on behalf of a relinquished newborn infant, an application for medical assistance benefits provided under the Illinois Public Aid Code and to provide all available medical information and records regarding the infant to the Department of Children and Family Services and to the child welfare agency (rather than child-placing agency) that has accepted the referral of the infant. Provides that if the person (rather than parent) who relinquished a newborn infant, or a person claiming to be the parent of the infant, returns to reclaim the infant within 30 days (rather than 72 hours) after the infant was relinquished to a police station, the police station must inform such person of the name and location of the hospital to which the infant was transported. Makes changes to provisions concerning information for a relinquishing person on the relinquishment process; a child welfare agency's authority to make medical and health related decisions for a relinquished infant; notice to the infant's biological parents of legal proceedings to terminate their parental rights; the appointment of a guardian ad litem to represent the infant's interests; the alternative to relinquishment that results in the adoption of a relinquished infant under 30 (rather than 7) days of age; and other matters. Amends the Abandoned Newborn Infant Protection Act, the Immunization Data Registry Act, the Illinois Parentage Act of 2015, and the Adoption Act by replacing all references to "child placing agency" with "child welfare agency".
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68	68	1 "Emergency medical professional" includes licensed
69	69	2 physicians, and any emergency medical technician, emergency
70	70	3 medical technician-intermediate, advanced emergency medical
71	71	4 technician, paramedic, trauma nurse specialist, and
72	72	5 pre-hospital registered nurse, as defined in the Emergency
73	73	6 Medical Services (EMS) Systems Act.
74	74	7 "Fire station" means a fire station within the State with
75	75	8 at least one staff person.
76	76	9 "Hospital" has the same meaning as in the Hospital
77	77	10 Licensing Act.
78	78	11 "Legal custody" means the relationship created by a court
79	79	12 order in the best interest of a newborn infant that imposes on
80	80	13 the infant's custodian the responsibility of physical
81	81	14 possession of the infant, the duty to protect, train, and
82	82	15 discipline the infant, and the duty to provide the infant with
83	83	16 food, shelter, education, and medical care, except as these
84	84	17 are limited by parental rights and responsibilities.
85	85	18 "Neglected child" has the same meaning as in the Abused
86	86	19 and Neglected Child Reporting Act.
87	87	20 "Newborn infant" means a child who a licensed physician
88	88	21 reasonably believes is 30 days old or less at the time the
89	89	22 child is initially relinquished to a hospital, police station,
90	90	23 fire station, or emergency medical facility, and who is not an
91	91	24 abused or a neglected child.
92	92	25 "Parent" or "biological parent" means a person who has
93	93	26 established maternity or paternity of the newborn infant
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104	104	1 through genetic testing.
105	105	2 "Police station" means a municipal police station, a
106	106	3 county sheriff's office, a campus police department located on
107	107	4 any college or university owned or controlled by the State or
108	108	5 any private college or private university that is not owned or
109	109	6 controlled by the State when employees of the campus police
110	110	7 department are present, or any of the district headquarters of
111	111	8 the Illinois State Police.
112	112	9 "Relinquish" means to bring a newborn infant, who a
113	113	10 licensed physician reasonably believes is 30 days old or less,
114	114	11 to a hospital, police station, fire station, or emergency
115	115	12 medical facility and to leave the infant with personnel of the
116	116	13 facility, if the person leaving the infant does not express an
117	117	14 intent to return for the infant or states that he or she will
118	118	15 not return for the infant. In the case of a mother who gives
119	119	16 birth to an infant in a hospital, the mother's act of leaving
120	120	17 that newborn infant at the hospital (i) without expressing an
121	121	18 intent to return for the infant or (ii) stating that she will
122	122	19 not return for the infant is not a "relinquishment" under this
123	123	20 Act.
124	124	21 "Temporary protective custody" means the temporary
125	125	22 placement of a newborn infant within a hospital or other
126	126	23 medical facility out of the custody of the infant's parent.
127	127	24 (Source: P.A. 97-293, eff. 8-11-11; 98-973, eff. 8-15-14.)
128	128	25 (325 ILCS 2/15)
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139	139	1 Sec. 15. Presumptions.
140	140	2 (a) There is a presumption that by relinquishing a newborn
141	141	3 infant in accordance with this Act, the infant's parent
142	142	4 consents to the termination of his or her parental rights with
143	143	5 respect to the infant and therefore waives notice of any legal
144	144	6 proceeding to terminate his or her parental rights.
145	145	7 (b) There is a presumption that a person relinquishing a
146	146	8 newborn infant in accordance with this Act:
147	147	9 (1) is the newborn infant's biological parent; and
148	148	10 (2) either without expressing an intent to return for
149	149	11 the infant or expressing an intent not to return for the
150	150	12 infant, did intend to relinquish the infant to the
151	151	13 hospital, police station, fire station, or emergency
152	152	14 medical facility to treat, care for, and provide for the
153	153	15 infant in accordance with this Act.
154	154	16 (c) A parent of a relinquished newborn infant may rebut
155	155	17 the presumption set forth in either subsection (a) or
156	156	18 subsection (b) pursuant to Section 55, at any time before the
157	157	19 termination of the parent's parental rights.
158	158	20 (Source: P.A. 92-408, eff. 8-17-01; 92-432, eff. 8-17-01;
159	159	21 93-820, eff. 7-27-04.)
160	160	22 (325 ILCS 2/20)
161	161	23 Sec. 20. Procedures with respect to relinquished newborn
162	162	24 infants.
163	163	25 (a) Hospitals. Every hospital must accept and provide all
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174	174	1 necessary emergency services and care to a relinquished
175	175	2 newborn infant, in accordance with this Act. The hospital
176	176	3 shall examine a relinquished newborn infant and perform tests
177	177	4 that, based on reasonable medical judgment, are appropriate in
178	178	5 evaluating whether the relinquished newborn infant was abused
179	179	6 or neglected.
180	180	7 The act of relinquishing a newborn infant serves as
181	181	8 implied consent for the hospital and its medical personnel and
182	182	9 physicians on staff to treat and provide care for the infant.
183	183	10 The hospital shall complete and submit an application for
184	184	11 medical assistance provided under Article V of the Illinois
185	185	12 Public Aid Code on behalf of the infant and shall provide all
186	186	13 available medical information and records regarding the infant
187	187	14 to the Department and the child welfare agency that has
188	188	15 accepted the referral of the infant in accordance with Section
189	189	16 50.
190	190	17 The hospital shall be deemed to have temporary protective
191	191	18 custody of a relinquished newborn infant until the infant is
192	192	19 discharged to the custody of a child welfare child-placing
193	193	20 agency or the Department.
194	194	21 (b) Fire stations and emergency medical facilities. Every
195	195	22 fire station and emergency medical facility must accept and
196	196	23 provide all necessary emergency services and care to a
197	197	24 relinquished newborn infant, in accordance with this Act.
198	198	25 The act of relinquishing a newborn infant serves as
199	199	26 implied consent for the fire station or emergency medical
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210	210	1 facility and its emergency medical professionals to treat and
211	211	2 provide care for the infant, to the extent that those
212	212	3 emergency medical professionals are trained to provide those
213	213	4 services.
214	214	5 After the relinquishment of a newborn infant to a fire
215	215	6 station or emergency medical facility, the fire station or
216	216	7 emergency medical facility's personnel must arrange for the
217	217	8 transportation of the infant to the nearest hospital as soon
218	218	9 as transportation can be arranged.
219	219	10 If the person who relinquished parent of a newborn infant,
220	220	11 or a person claiming to be the parent of the infant, returns to
221	221	12 reclaim the infant within 30 days child within 72 hours after
222	222	13 the infant was relinquished relinquishing the child to a fire
223	223	14 station or emergency medical facility, the fire station or
224	224	15 emergency medical facility must inform such person the parent
225	225	16 of the name and location of the hospital to which the infant
226	226	17 was transported.
227	227	18 (c) Police stations. Every police station must accept a
228	228	19 relinquished newborn infant, in accordance with this Act.
229	229	20 After the relinquishment of a newborn infant to a police
230	230	21 station, the police station must arrange for the
231	231	22 transportation of the infant to the nearest hospital as soon
232	232	23 as transportation can be arranged. The act of relinquishing a
233	233	24 newborn infant serves as implied consent for the hospital to
234	234	25 which the infant is transported and that hospital's medical
235	235	26 personnel and physicians on staff to treat and provide care
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246	246	1 for the infant.
247	247	2 If the person who relinquished parent of a newborn infant,
248	248	3 or a person claiming to be the parent of the infant, returns to
249	249	4 reclaim the infant within 30 days 72 hours after relinquishing
250	250	5 the infant was relinquished to a police station, the police
251	251	6 station must inform such person the parent of the name and
252	252	7 location of the hospital to which the infant was transported.
253	253	8 (Source: P.A. 92-408, eff. 8-17-01; 92-432, eff. 8-17-01;
254	254	9 93-820, eff. 7-27-04.)
255	255	10 (325 ILCS 2/22)
256	256	11 Sec. 22. Signs. Every hospital, fire station, emergency
257	257	12 medical facility, and police station that is required to
258	258	13 accept a relinquished newborn infant in accordance with this
259	259	14 Act must post, either by physical or electronic means, a sign
260	260	15 in a conspicuous place on the exterior of the building housing
261	261	16 the facility informing persons that a newborn infant may be
262	262	17 relinquished at the facility in accordance with this Act. The
263	263	18 Department shall prescribe specifications for the signs and
264	264	19 for their placement that will ensure statewide uniformity.
265	265	20 This Section does not apply to a hospital, fire station,
266	266	21 emergency medical facility, or police station that has a sign
267	267	22 that is consistent with the requirements of this Section that
268	268	23 is posted on the effective date of this amendatory Act of the
269	269	24 95th General Assembly.
270	270	25 (Source: P.A. 102-4, eff. 4-27-21.)
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281	281	1 (325 ILCS 2/30)
282	282	2 Sec. 30. Anonymity of relinquishing person. If there is
283	283	3 no evidence of abuse or neglect of a relinquished newborn
284	284	4 infant, the relinquishing person has the right to remain
285	285	5 anonymous and to leave the hospital, police station, fire
286	286	6 station, or emergency medical facility at any time and not be
287	287	7 pursued or followed. Before the relinquishing person leaves
288	288	8 the hospital, police station, fire station, or emergency
289	289	9 medical facility, the hospital, police station, fire station,
290	290	10 or emergency medical facility personnel shall (i) verbally
291	291	11 inform the relinquishing person that by relinquishing the
292	292	12 child anonymously, he or she will have to petition the court if
293	293	13 he or she desires to prevent the termination of parental
294	294	14 rights and regain custody of the child and (ii) shall offer the
295	295	15 relinquishing person the information packet described in
296	296	16 Section 35 of this Act. However, nothing in this Act shall be
297	297	17 construed as precluding the relinquishing person from
298	298	18 providing his or her identity or completing the application
299	299	19 forms for the Illinois Adoption Registry and Medical
300	300	20 Information Exchange and requesting that the hospital, police
301	301	21 station, fire station, or emergency medical facility forward
302	302	22 those forms to the Illinois Adoption Registry and Medical
303	303	23 Information Exchange.
304	304	24 (Source: P.A. 92-408, eff. 8-17-01; 92-432, eff. 8-17-01;
305	305	25 93-820, eff. 7-27-04.)
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316	316	1 (325 ILCS 2/35)
317	317	2 Sec. 35. Information for relinquishing person.
318	318	3 (a) The A hospital, police station, fire station, or
319	319	4 emergency medical facility that receives a newborn infant
320	320	5 relinquished in accordance with this Act shall must offer
321	321	6 information about the relinquishment process to an information
322	322	7 packet to the relinquishing person and, if possible, must
323	323	8 clearly inform the relinquishing person either in writing or
324	324	9 by referring said person to a website or other electronic
325	325	10 resource. Such information shall clearly state that his or her
326	326	11 acceptance of the information is completely voluntary. The
327	327	12 information packet must include all of the following:
328	328	13 (1) (Blank).
329	329	14 (2) Written notice of the following:
330	330	15 (A) No sooner than 60 days following the date of
331	331	16 the initial relinquishment of the infant to a
332	332	17 hospital, police station, fire station, or emergency
333	333	18 medical facility, the court may enter an order
334	334	19 terminating parental rights without notice to the
335	335	20 parents of the infant child-placing agency or the
336	336	21 Department will commence proceedings for the
337	337	22 termination of parental rights and placement of the
338	338	23 infant for adoption.
339	339	24 (B) Failure of a parent of the infant to contact
340	340	25 the Department and petition for the return of custody
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351	351	1 of the infant before termination of parental rights
352	352	2 bars any future action asserting legal rights with
353	353	3 respect to the infant.
354	354	4 (3) A resource list of providers of counseling
355	355	5 services including grief counseling, pregnancy counseling,
356	356	6 and counseling regarding adoption and other available
357	357	7 options for placement of the infant.
358	358	8 Upon request of a parent, the Department of Public Health
359	359	9 shall provide the application forms for the Illinois Adoption
360	360	10 Registry and Medical Information Exchange.
361	361	11 (b) The information offered packet given to a
362	362	12 relinquishing person parent in accordance with this Act shall
363	363	13 include, in addition to other information required under this
364	364	14 Act, the following:
365	365	15 (1) Information A brochure (with a self-mailer
366	366	16 attached) that describes this Act and the rights of birth
367	367	17 parents, including an option optional section for the
368	368	18 parent to complete and mail to the Department of Children
369	369	19 and Family Services a form , that shall ask for basic
370	370	20 anonymous background information about the relinquished
371	371	21 child. This form brochure shall be maintained by the
372	372	22 Department on its website.
373	373	23 (2) Information about A brochure that describes the
374	374	24 Illinois Adoption Registry, including a toll-free number
375	375	25 and website information. This brochure shall be maintained
376	376	26 on the Office of Vital Records website.
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387	387	1 (3) Information about a mother's postpartum health A
388	388	2 brochure describing postpartum health information for the
389	389	3 mother.
390	390	4 The information provided in writing or through electronic
391	391	5 means packet shall be designed in coordination between the
392	392	6 Office of Vital Records and the Department of Children and
393	393	7 Family Services. The failure to provide such information under
394	394	8 this Section, or the failure of the relinquishing person to
395	395	9 accept such information, shall not invalidate the
396	396	10 relinquishment under this Act. , with the exception of the
397	397	11 resource list of providers of counseling services and adoption
398	398	12 agencies, which shall be provided by the hospital, fire
399	399	13 station, police station, sheriff's office, or emergency
400	400	14 medical facility.
401	401	15 (Source: P.A. 96-1114, eff. 7-20-10; 97-333, eff. 8-12-11.)
402	402	16 (325 ILCS 2/37)
403	403	17 Sec. 37. Public disclosure of information prohibited.
404	404	18 Emergency medical professionals, employees, or other persons
405	405	19 engaged in the administration or operation of a fire station,
406	406	20 police station, hospital, emergency medical facility, child
407	407	21 welfare placing agency, or the Department where a newborn
408	408	22 infant baby has been relinquished or transferred under this
409	409	23 Act, are prohibited from publicly disclosing any information
410	410	24 concerning the relinquishment of the infant and the
411	411	25 individuals involved, except as otherwise provided by law.
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422	422	1 (Source: P.A. 95-549, eff. 6-1-08.)
423	423	2 (325 ILCS 2/40)
424	424	3 Sec. 40. Reporting requirements.
425	425	4 (a) Within 12 hours after accepting a newborn infant from
426	426	5 a relinquishing person or from a police station, fire station,
427	427	6 or emergency medical facility in accordance with this Act, a
428	428	7 hospital must report to the Department's State Central
429	429	8 Registry for the purpose of transferring physical custody of
430	430	9 the infant from the hospital to either a child welfare
431	431	10 child-placing agency or the Department.
432	432	11 (b) Within 24 hours after receiving a report under
433	433	12 subsection (a), the Department must request assistance from
434	434	13 law enforcement officials to investigate the matter using the
435	435	14 National Crime Information Center to ensure that the
436	436	15 relinquished newborn infant is not a missing child.
437	437	16 (c) Once a hospital has made a report to the Department
438	438	17 under subsection (a), the Department must arrange for a
439	439	18 licensed child welfare child-placing agency to accept physical
440	440	19 custody of the relinquished newborn infant.
441	441	20 (d) If a relinquished child is not a newborn infant as
442	442	21 defined in this Act, the hospital and the Department must
443	443	22 proceed as if the child is an abused or neglected child.
444	444	23 (Source: P.A. 92-408, eff. 8-17-01; 92-432, eff. 8-17-01;
445	445	24 93-820, eff. 7-27-04.)
446	446
447	447
448	448
449	449
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456	456	1 (325 ILCS 2/50)
457	457	2 Sec. 50. Child welfare Child-placing agency procedures.
458	458	3 (a) The Department's State Central Registry must maintain
459	459	4 a list of licensed child welfare child-placing agencies
460	460	5 willing to take legal custody of newborn infants relinquished
461	461	6 in accordance with this Act. The child welfare child-placing
462	462	7 agencies on the list must be contacted by the Department on a
463	463	8 rotating basis upon notice from a hospital that a newborn
464	464	9 infant has been relinquished in accordance with this Act.
465	465	10 (b) Upon notice from the Department that a newborn infant
466	466	11 has been relinquished in accordance with this Act, a child
467	467	12 welfare child-placing agency must accept the newborn infant if
468	468	13 the agency has the accommodations to do so. The child welfare
469	469	14 child-placing agency must seek an order for legal custody of
470	470	15 the infant upon its acceptance of the infant.
471	471	16 (c) Within 3 business days after accepting the referral
472	472	17 from the Department, assuming physical custody of the infant,
473	473	18 the child welfare child-placing agency shall file a petition
474	474	19 for custody in the division of the circuit court in which
475	475	20 petitions for adoption would normally be heard. The infant
476	476	21 shall be referred to as "Baby Girl Doe" or "Baby Boy Doe" in
477	477	22 all pleadings, notwithstanding actual knowledge of the
478	478	23 infant's name or of the names of the infant's alleged parents,
479	479	24 in order to preserve the confidentiality of the relinquishing
480	480	25 parent or parents and the expectation of anonymity consistent
481	481	26 with the purposes of this Act. The petition for custody shall
482	482
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492	492	1 allege that the newborn infant has been relinquished in
493	493	2 accordance with this Act and shall request state that the
494	494	3 child welfare child-placing agency be given the authority
495	495	4 intends to place the infant in an adoptive home, foster home,
496	496	5 child care facility, or other facility appropriate for the
497	497	6 needs of the infant. No filing or appearance fees shall be
498	498	7 charged to any petitioner.
499	499	8 (d) If no licensed child welfare child-placing agency is
500	500	9 able to accept the relinquished newborn infant, then the
501	501	10 Department must assume responsibility for the infant as soon
502	502	11 as practicable.
503	503	12 (e) A custody order issued under subsection (b) shall
504	504	13 grant the child welfare agency the authority to make medical
505	505	14 and health related decisions for the infant. Said order shall
506	506	15 remain in effect until a final adoption order based on the
507	507	16 relinquished newborn infant's best interests is issued in
508	508	17 accordance with this Act and the Adoption Act.
509	509	18 (f) When possible, the child welfare child-placing agency
510	510	19 must place a relinquished newborn infant in a prospective
511	511	20 adoptive home.
512	512	21 (g) An order terminating the parental rights of the
513	513	22 biological parents of the infant and appointing a guardian of
514	514	23 the infant with authority to consent to the adoption may be
515	515	24 entered The Department or child-placing agency must initiate
516	516	25 proceedings to (i) terminate the parental rights of the
517	517	26 relinquished newborn infant's known or unknown parents, (ii)
518	518
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528	528	1 appoint a guardian for the infant, and (iii) obtain consent to
529	529	2 the infant's adoption in accordance with this Act no sooner
530	530	3 than 60 days following the date of the initial relinquishment
531	531	4 of the infant to the hospital, police station, fire station,
532	532	5 or emergency medical facility.
533	533	6 (g-1) Notice to the infant's biological parents of the
534	534	7 legal proceedings under this Act shall be given by publication
535	535	8 of a notice in a newspaper published in the county in which the
536	536	9 action is pending, or if there is no newspaper published in
537	537	10 that county, then in a newspaper published in an adjoining
538	538	11 county having a circulation in the county in which the action
539	539	12 is pending. The form to be used for publication shall be
540	540	13 substantially as follows:
541	541	14 "ABANDONED NEWBORN NOTICE STATE OF ILLINOIS, County of
542	542	15 ...., ss,--Circuit Court of ...... County, In the matter of
543	543	16 the Abandonment of BABY (GIRL/BOY) DOE, a newborn infant, Case
544	544	17 Number .......... To THE UNKNOWN MOTHER, UNKNOWN FATHER and
545	545	18 ALL WHOM IT MAY CONCERN: Take notice that a Petition was filed
546	546	19 in the Circuit Court of ........ County, Illinois, for an
547	547	20 unnamed child, referred to as BABY (GIRL/BOY) DOE, born on or
548	548	21 about ......, and relinquished to ............. on or about
549	549	22 ..........., pursuant to the Abandoned Newborn Infant
550	550	23 Protection Act. Now therefore, unless you UNKNOWN MOTHER,
551	551	24 UNKNOWN FATHER and ALL WHOM IT MAY CONCERN, file your petition
552	552	25 for return of custody in the said Circuit Court of .... County,
553	553	26 ..............., in the city of .........., Illinois, on or
554	554
555	555
556	556
557	557
558	558
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564	564	1 before .........., an order terminating your parental rights
565	565	2 may be entered against you any time after that day and a
566	566	3 judgment may be entered in accordance with the Petition.
567	567	4 (E-filing instructions, Contact information for the attorney
568	568	5 for the petition)"
569	569	6 Notwithstanding actual knowledge, the name of the
570	570	7 relinquishing parent, alleged parent, or infant shall not be
571	571	8 included in the publication notice in order to preserve
572	572	9 confidentiality and anonymity consistent with the purpose of
573	573	10 this Act. No further notice is required unless a person
574	574	11 claiming to be the infant's parent files a petition in
575	575	12 accordance with Section 55 of this Act, or a possible parent is
576	576	13 discovered as a result of the required procedures in
577	577	14 subsection (h).
578	578	15 (h) Before requesting an order filing a petition for
579	579	16 termination of parental rights, the Department or child
580	580	17 welfare child-placing agency must do the following:
581	581	18 (1) If the name of either biological parent or alleged
582	582	19 parent is known, search the Illinois Search its Putative
583	583	20 Father Registry for the purpose of determining the
584	584	21 identity and location of the putative father of the
585	585	22 relinquished newborn infant who is, or is expected to be,
586	586	23 the subject of an adoption proceeding, in order to provide
587	587	24 notice of the proceeding to the putative father. At least
588	588	25 one search of the Registry must be conducted, at least 30
589	589	26 days after the relinquished newborn infant's estimated
590	590
591	591
592	592
593	593
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600	600	1 date of birth; earlier searches may be conducted, however.
601	601	2 Notice to any potential putative father discovered in a
602	602	3 search of the Registry according to the estimated age of
603	603	4 the relinquished newborn infant must be in accordance with
604	604	5 the Code of Civil Procedure or Section 12a of the Adoption
605	605	6 Act. If the names of all alleged parents are unknown, then
606	606	7 a search is not required under this Section.
607	607	8 (2) Verify with the Department that, in accordance
608	608	9 with subsection (b) of Section 40, that law enforcement
609	609	10 officials, using the National Crime Information Center,
610	610	11 that the relinquished newborn infant is not a missing
611	611	12 child.
612	612	13 (3) Publish notice in accordance with subsection
613	613	14 (g-1).
614	614	15 (Source: P.A. 92-408, eff. 8-17-01; 92-432, eff. 8-17-01;
615	615	16 93-820, eff. 7-27-04.)
616	616	17 (325 ILCS 2/55)
617	617	18 Sec. 55. Petition for return of custody.
618	618	19 (a) A parent or person claiming to be a parent of a newborn
619	619	20 infant relinquished in accordance with this Act may petition
620	620	21 for the return of custody of the infant before the termination
621	621	22 of parental rights with respect to the infant.
622	622	23 (b) A parent of a newborn infant relinquished in
623	623	24 accordance with this Act may petition for the return of
624	624	25 custody of the infant by contacting the Department for the
625	625
626	626
627	627
628	628
629	629
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631	631
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635	635	1 purpose of obtaining the name of the child welfare -placing
636	636	2 agency with custody of the infant and the appropriate court in
637	637	3 which the petition of return of custody of the infant must be
638	638	4 filed and then filing a petition for return of custody in the
639	639	5 circuit court in which the proceeding for the termination of
640	640	6 parental rights is pending. No filing or appearance fees shall
641	641	7 be charged to any petitioner.
642	642	8 (c) (Blank). If a petition for the termination of parental
643	643	9 rights has not been filed by the Department or the
644	644	10 child-placing agency, the parent of the relinquished newborn
645	645	11 infant must contact the Department, which must notify the
646	646	12 parent of the appropriate court in which the petition for
647	647	13 return of custody must be filed.
648	648	14 (d) The circuit court may hold the proceeding for the
649	649	15 termination of parental rights in abeyance for a period not to
650	650	16 exceed 60 days from the date that the petition for return of
651	651	17 custody was filed without a showing of good cause. During that
652	652	18 period:
653	653	19 (1) The court shall order genetic testing to establish
654	654	20 maternity or paternity, or both.
655	655	21 (2) The Department shall conduct a child protective
656	656	22 investigation and home study to develop recommendations to
657	657	23 the court.
658	658	24 (3) When indicated as a result of the Department's
659	659	25 investigation and home study, further proceedings under
660	660	26 the Juvenile Court Act of 1987 as the court determines
661	661
662	662
663	663
664	664
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671	671	1 appropriate, may be conducted. However, relinquishment of
672	672	2 a newborn infant in accordance with this Act does not
673	673	3 render the infant abused, neglected, or abandoned solely
674	674	4 because the newborn infant was relinquished to a hospital,
675	675	5 police station, fire station, or emergency medical
676	676	6 facility in accordance with this Act.
677	677	7 (4) The court shall appoint a guardian ad litem to
678	678	8 represent the interests of the newborn infant.
679	679	9 (e) Failure to file a petition for the return of custody of
680	680	10 a relinquished newborn infant before the termination of
681	681	11 parental rights bars any future action asserting legal rights
682	682	12 with respect to the infant unless the parent's act of
683	683	13 relinquishment that led to the termination of parental rights
684	684	14 involved fraud perpetrated against and not stemming from or
685	685	15 involving the parent of the newborn infant. No action to void
686	686	16 or revoke the termination of parental rights of a parent of a
687	687	17 newborn infant relinquished in accordance with this Act,
688	688	18 including an action based on fraud, may be commenced after 12
689	689	19 months after the date that the newborn infant was initially
690	690	20 relinquished to a hospital, police station, fire station, or
691	691	21 emergency medical facility.
692	692	22 (Source: P.A. 92-408, eff. 8-17-01; 92-432, eff. 8-17-01;
693	693	23 93-820, eff. 7-27-04.)
694	694	24 (325 ILCS 2/60)
695	695	25 Sec. 60. Department's duties. The Department must
696	696
697	697
698	698
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706	706	1 implement a public information program to promote safe
707	707	2 placement alternatives for newborn infants. The public
708	708	3 information program must inform the public of the following:
709	709	4 (1) The relinquishment alternative provided for in
710	710	5 this Act, which results in the adoption of a newborn
711	711	6 infant relinquished under 30 7 days of age and which
712	712	7 provides for the parent's anonymity, if the parent so
713	713	8 chooses.
714	714	9 (2) The alternative of adoption through a public or
715	715	10 private agency, in which the parent's identity may or may
716	716	11 not be known to the agency, but is kept anonymous from the
717	717	12 adoptive parents, if the birth parent so desires, and
718	718	13 which allows the parent to be actively involved in the
719	719	14 child's adoption plan.
720	720	15 The public information program may include, but need not
721	721	16 be limited to, the following elements:
722	722	17 (i) Educational and informational materials in print,
723	723	18 audio, video, electronic or other media.
724	724	19 (ii) Establishment of a web site.
725	725	20 (iii) Public service announcements and advertisements.
726	726	21 (iv) Establishment of toll-free telephone hotlines to
727	727	22 provide information.
728	728	23 (Source: P.A. 94-941, eff. 6-26-06.)
729	729	24 (325 ILCS 2/65)
730	730	25 Sec. 65. Evaluation.
731	731
732	732
733	733
734	734
735	735
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738	738
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741	741	1 (a) The Department shall collect and analyze information
742	742	2 regarding the relinquishment of newborn infants and placement
743	743	3 of children under this Act. Police stations, fire stations,
744	744	4 emergency medical facilities, and medical professionals
745	745	5 accepting and providing services to a newborn infant under
746	746	6 this Act shall report to the Department data necessary for the
747	747	7 Department to evaluate and determine the effect of this Act in
748	748	8 the prevention of injury or death of newborn infants. Child
749	749	9 welfare Child-placing agencies shall report to the Department
750	750	10 data necessary to evaluate and determine the effectiveness of
751	751	11 these agencies in providing child protective and child welfare
752	752	12 services to newborn infants relinquished under this Act.
753	753	13 (b) The information collected shall include, but need not
754	754	14 be limited to: the number of newborn infants relinquished; the
755	755	15 category of the place of relinquishment (hospital, police
756	756	16 station, fire station, or emergency medical facility); the
757	757	17 services provided to relinquished newborn infants; the outcome
758	758	18 of care for the relinquished newborn infants; the number and
759	759	19 disposition of cases of relinquished newborn infants subject
760	760	20 to placement; the number of children accepted and served by
761	761	21 child welfare child-placing agencies; and the services
762	762	22 provided by child welfare child-placing agencies and the
763	763	23 disposition of the cases of the children placed under this
764	764	24 Act.
765	765	25 (c) The Department shall submit a report by January 1,
766	766	26 2002, and on January 1 of each year thereafter, to the Governor
767	767
768	768
769	769
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777	777	1 and General Assembly regarding the prevention of injury or
778	778	2 death of newborn infants and the effect of placements of
779	779	3 children under this Act. The report shall include, but need
780	780	4 not be limited to, a summary of collected data, an analysis of
781	781	5 the data and conclusions regarding the Act's effectiveness, a
782	782	6 determination whether the purposes of the Act are being
783	783	7 achieved, and recommendations for changes that may be
784	784	8 considered necessary to improve the administration and
785	785	9 enforcement of this Act.
786	786	10 (Source: P.A. 92-408, eff. 8-17-01; 92-432, eff. 8-17-01;
787	787	11 93-820, eff. 7-27-04.)
788	788	12 Section 10. The Immunization Data Registry Act is amended
789	789	13 by changing Section 20 as follows:
790	790	14 (410 ILCS 527/20)
791	791	15 Sec. 20. Confidentiality of information; release of
792	792	16 information; statistics; panel on expanding access.
793	793	17 (a) Records maintained as part of the immunization data
794	794	18 registry are confidential.
795	795	19 (b) The Department may release an individual's
796	796	20 confidential information to the individual or to the
797	797	21 individual's parent or guardian if the individual is less than
798	798	22 18 years of age.
799	799	23 (c) Subject to subsection (d) of this Section, the
800	800	24 Department may release information in the immunization data
801	801
802	802
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811	811	1 registry concerning an individual to the following entities:
812	812	2 (1) The immunization data registry of another state.
813	813	3 (2) A health care provider or a health care provider's
814	814	4 designee.
815	815	5 (3) A local health department.
816	816	6 (4) An elementary or secondary school that is attended
817	817	7 by the individual.
818	818	8 (5) A licensed child care center in which the
819	819	9 individual is enrolled.
820	820	10 (6) A licensed child welfare child-placing agency.
821	821	11 (7) A college or university that is attended by the
822	822	12 individual.
823	823	13 (8) The Department of Healthcare and Family Services
824	824	14 or a managed care entity contracted with the Department of
825	825	15 Healthcare and Family Services to coordinate the provision
826	826	16 of medical care to enrollees of the medical assistance
827	827	17 program.
828	828	18 (d) Before immunization data may be released to an entity,
829	829	19 the entity must enter into an agreement with the Department
830	830	20 that provides that information that identifies a patient will
831	831	21 not be released to any other person without the written
832	832	22 consent of the patient.
833	833	23 (e) The Department may release summary statistics
834	834	24 regarding information in the immunization data registry if the
835	835	25 summary statistics do not reveal the identity of an
836	836	26 individual.
837	837
838	838
839	839
840	840
841	841
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843	843
844	844
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847	847	1 (Source: P.A. 97-117, eff. 7-14-11; 98-651, eff. 6-16-14.)
848	848	2 Section 15. The Illinois Parentage Act of 2015 is amended
849	849	3 by changing Section 602 as follows:
850	850	4 (750 ILCS 46/602)
851	851	5 Sec. 602. Standing. A complaint to adjudicate parentage
852	852	6 shall be verified, shall be designated a petition, and shall
853	853	7 name the person or persons alleged to be the parent of the
854	854	8 child. Subject to Article 3 and Sections 607, 608, and 609 of
855	855	9 this Act, a proceeding to adjudicate parentage may be
856	856	10 maintained by:
857	857	11 (a) the child;
858	858	12 (b) the mother of the child;
859	859	13 (c) a pregnant woman;
860	860	14 (d) a man presumed or alleging himself to be the
861	861	15 parent of the child;
862	862	16 (e) a woman presumed or alleging herself to be the
863	863	17 parent of the child;
864	864	18 (f) the support-enforcement agency or other
865	865	19 governmental agency authorized by other law;
866	866	20 (g) any person or public agency that has physical
867	867	21 possession of or has custody of or has been allocated
868	868	22 parental responsibilities for, is providing financial
869	869	23 support to, or has provided financial support to the
870	870	24 child;
871	871
872	872
873	873
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881	881	1 (h) the Department of Healthcare and Family Services
882	882	2 if it is providing, or has provided, financial support to
883	883	3 the child or if it is assisting with child support
884	884	4 collections services;
885	885	5 (i) an authorized adoption agency or licensed child
886	886	6 welfare child-placing agency;
887	887	7 (j) a representative authorized by law to act for an
888	888	8 individual who would otherwise be entitled to maintain a
889	889	9 proceeding but who is deceased, incapacitated, or a minor;
890	890	10 or
891	891	11 (k) an intended parent.
892	892	12 (Source: P.A. 99-85, eff. 1-1-16; 99-769, eff. 1-1-17.)
893	893	13 Section 20. The Adoption Act is amended by changing
894	894	14 Sections 4.1 and 10 as follows:
895	895	15 (750 ILCS 50/4.1) (from Ch. 40, par. 1506)
896	896	16 Sec. 4.1. Adoption between multiple jurisdictions. It is
897	897	17 the public policy of this State to promote child welfare in
898	898	18 adoption between multiple jurisdictions by implementing
899	899	19 standards that foster permanency for children in an
900	900	20 expeditious manner while considering the best interests of the
901	901	21 child as paramount. Ensuring that standards for
902	902	22 interjurisdictional adoption are clear and applied
903	903	23 consistently, efficiently, and reasonably will promote the
904	904	24 best interests of the child in finding a permanent home.
905	905
906	906
907	907
908	908
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915	915	1 (a) The Department of Children and Family Services shall
916	916	2 promulgate rules regarding the approval and regulation of
917	917	3 agencies providing, in this State, adoption services, as
918	918	4 defined in Section 2.24 of the Child Care Act of 1969, which
919	919	5 shall include, but not be limited to, a requirement that any
920	920	6 agency shall be licensed in this State as a child welfare
921	921	7 agency as defined in Section 2.08 of the Child Care Act of
922	922	8 1969. Any out-of-state agency, if not licensed in this State
923	923	9 as a child welfare agency, must obtain the approval of the
924	924	10 Department in order to act as a sending agency, as defined in
925	925	11 Section 1 of the Interstate Compact on Placement of Children
926	926	12 Act, seeking to place a child into this State through a
927	927	13 placement subject to the Interstate Compact on the Placement
928	928	14 of Children. An out-of-state agency, if not licensed in this
929	929	15 State as a child welfare agency, is prohibited from providing
930	930	16 in this State adoption services, as defined by Section 2.24 of
931	931	17 the Child Care Act of 1969; shall comply with Section 12C-70 of
932	932	18 the Criminal Code of 2012; and shall provide all of the
933	933	19 following to the Department:
934	934	20 (1) A copy of the agency's current license or other
935	935	21 form of authorization from the approving authority in the
936	936	22 agency's state. If no license or authorization is issued,
937	937	23 the agency must provide a reference statement, from the
938	938	24 approving authority, stating that the agency is authorized
939	939	25 to place children in foster care or adoption or both in its
940	940	26 jurisdiction.
941	941
942	942
943	943
944	944
945	945
946	946	HB3101 - 26 - LRB103 29344 KTG 55731 b
947	947
948	948
949	949	HB3101- 27 -LRB103 29344 KTG 55731 b HB3101 - 27 - LRB103 29344 KTG 55731 b
950	950	HB3101 - 27 - LRB103 29344 KTG 55731 b
951	951	1 (2) A description of the program, including home
952	952	2 studies, placements, and supervisions, that the child
953	953	3 welfare child placing agency conducts within its
954	954	4 geographical area, and, if applicable, adoptive placements
955	955	5 and the finalization of adoptions. The child welfare child
956	956	6 placing agency must accept continued responsibility for
957	957	7 placement planning and replacement if the placement fails.
958	958	8 (3) Notification to the Department of any significant
959	959	9 child welfare child placing agency changes after approval.
960	960	10 (4) Any other information the Department may require.
961	961	11 The rules shall also provide that any agency that places
962	962	12 children for adoption in this State may not, in any policy or
963	963	13 practice relating to the placement of children for adoption,
964	964	14 discriminate against any child or prospective adoptive parent
965	965	15 on the basis of race.
966	966	16 (a-5) (Blank).
967	967	17 (b) Interstate adoptions.
968	968	18 (1) All interstate adoption placements under this Act
969	969	19 shall comply with the Child Care Act of 1969 and the
970	970	20 Interstate Compact on the Placement of Children. The
971	971	21 placement of children with relatives by the Department of
972	972	22 Children and Family Services shall also comply with
973	973	23 subsection (b) of Section 7 of the Children and Family
974	974	24 Services Act. The Department may promulgate rules to
975	975	25 implement interstate adoption placements, including those
976	976	26 requirements set forth in this Section.
977	977
978	978
979	979
980	980
981	981
982	982	HB3101 - 27 - LRB103 29344 KTG 55731 b
983	983
984	984
985	985	HB3101- 28 -LRB103 29344 KTG 55731 b HB3101 - 28 - LRB103 29344 KTG 55731 b
986	986	HB3101 - 28 - LRB103 29344 KTG 55731 b
987	987	1 (2) If an adoption is finalized prior to bringing or
988	988	2 sending a child to this State, compliance with the
989	989	3 Interstate Compact on the Placement of Children is not
990	990	4 required.
991	991	5 (3) Approval requirements. The Department shall
992	992	6 promulgate procedures for interstate adoption placements
993	993	7 of children under this Act. No later than September 24,
994	994	8 2017 (30 days after the effective date of Public Act
995	995	9 100-344), the Department shall distribute a written list
996	996	10 of all preadoption approval requirements to all Illinois
997	997	11 licensed child welfare agencies performing adoption
998	998	12 services, and all out-of-state agencies approved under
999	999	13 this Section, and shall post the requirements on the
1000	1000	14 Department's website. The Department may not require any
1001	1001	15 further preadoption requirements other than those set
1002	1002	16 forth in the procedures required under this paragraph. The
1003	1003	17 procedures shall reflect the standard of review as stated
1004	1004	18 in the Interstate Compact on the Placement of Children and
1005	1005	19 approval shall be given by the Department if the placement
1006	1006	20 appears not to be contrary to the best interests of the
1007	1007	21 child.
1008	1008	22 (4) Time for review and decision. In all cases where
1009	1009	23 the child to be placed is not a youth in care in Illinois
1010	1010	24 or any other state, a provisional or final approval for
1011	1011	25 placement shall be provided in writing from the Department
1012	1012	26 in accordance with the Interstate Compact on the Placement
1013	1013
1014	1014
1015	1015
1016	1016
1017	1017
1018	1018	HB3101 - 28 - LRB103 29344 KTG 55731 b
1019	1019
1020	1020
1021	1021	HB3101- 29 -LRB103 29344 KTG 55731 b HB3101 - 29 - LRB103 29344 KTG 55731 b
1022	1022	HB3101 - 29 - LRB103 29344 KTG 55731 b
1023	1023	1 of Children. Approval or denial of the placement must be
1024	1024	2 given by the Department as soon as practicable, but in no
1025	1025	3 event more than 3 business days of the receipt of the
1026	1026	4 completed referral packet by the Department's Interstate
1027	1027	5 Compact Administrator. Receipt of the packet shall be
1028	1028	6 evidenced by the packet's arrival at the address
1029	1029	7 designated by the Department to receive such referrals.
1030	1030	8 The written decision to approve or deny the placement
1031	1031	9 shall be communicated in an expeditious manner, including,
1032	1032	10 but not limited to, electronic means referenced in
1033	1033	11 paragraph (b)(7) of this Section, and shall be provided to
1034	1034	12 all Illinois licensed child welfare agencies involved in
1035	1035	13 the placement, all out-of-state child placing agencies
1036	1036	14 involved in the placement, and all attorneys representing
1037	1037	15 the prospective adoptive parent or biological parent. If,
1038	1038	16 during its initial review of the packet, the Department
1039	1039	17 believes there are any incomplete or missing documents, or
1040	1040	18 missing information, as required in paragraph (b)(3), the
1041	1041	19 Department shall, as soon as practicable, but in no event
1042	1042	20 more than 2 business days of receipt of the packet,
1043	1043	21 communicate a list of any incomplete or missing documents
1044	1044	22 and information to all Illinois licensed child welfare
1045	1045	23 agencies involved in the placement, all out-of-state child
1046	1046	24 placing agencies involved in the placement, and all
1047	1047	25 attorneys representing the adoptive parent or biological
1048	1048	26 parent. This list shall be communicated in an expeditious
1049	1049
1050	1050
1051	1051
1052	1052
1053	1053
1054	1054	HB3101 - 29 - LRB103 29344 KTG 55731 b
1055	1055
1056	1056
1057	1057	HB3101- 30 -LRB103 29344 KTG 55731 b HB3101 - 30 - LRB103 29344 KTG 55731 b
1058	1058	HB3101 - 30 - LRB103 29344 KTG 55731 b
1059	1059	1 manner, including, but not limited to, electronic means
1060	1060	2 referenced in paragraph (b)(7) of this Section.
1061	1061	3 (5) Denial of approval. In all cases where the child
1062	1062	4 to be placed is not a youth in the care of any state, if
1063	1063	5 the Department denies approval of an interstate placement,
1064	1064	6 the written decision referenced in paragraph (b)(4) of
1065	1065	7 this Section shall set forth the reason or reasons why the
1066	1066	8 placement was not approved and shall reference which
1067	1067	9 requirements under paragraph (b)(3) of this Section were
1068	1068	10 not met. The written decision shall be communicated in an
1069	1069	11 expeditious manner, including, but not limited to,
1070	1070	12 electronic means referenced in paragraph (b)(7) of this
1071	1071	13 Section, to all Illinois licensed child welfare agencies
1072	1072	14 involved in the placement, all out-of-state child placing
1073	1073	15 agencies involved in the placement, and all attorneys
1074	1074	16 representing the prospective adoptive parent or biological
1075	1075	17 parent.
1076	1076	18 (6) Provisional approval. Nothing in paragraphs (b)(3)
1077	1077	19 through (b)(5) of this Section shall preclude the
1078	1078	20 Department from issuing provisional approval of the
1079	1079	21 placement pending receipt of any missing or incomplete
1080	1080	22 documents or information.
1081	1081	23 (7) Electronic communication. All communications
1082	1082	24 concerning an interstate placement made between the
1083	1083	25 Department and an Illinois licensed child welfare agency,
1084	1084	26 an out-of-state child placing agency, and attorneys
1085	1085
1086	1086
1087	1087
1088	1088
1089	1089
1090	1090	HB3101 - 30 - LRB103 29344 KTG 55731 b
1091	1091
1092	1092
1093	1093	HB3101- 31 -LRB103 29344 KTG 55731 b HB3101 - 31 - LRB103 29344 KTG 55731 b
1094	1094	HB3101 - 31 - LRB103 29344 KTG 55731 b
1095	1095	1 representing the prospective adoptive parent or biological
1096	1096	2 parent, including the written communications referenced in
1097	1097	3 this Section, may be made through any type of electronic
1098	1098	4 means, including, but not limited to, electronic mail.
1099	1099	5 (c) Intercountry adoptions. The adoption of a child, if
1100	1100	6 the child is a habitual resident of a country other than the
1101	1101	7 United States and the petitioner is a habitual resident of the
1102	1102	8 United States, or, if the child is a habitual resident of the
1103	1103	9 United States and the petitioner is a habitual resident of a
1104	1104	10 country other than the United States, shall comply with the
1105	1105	11 Intercountry Adoption Act of 2000, as amended, and the
1106	1106	12 Immigration and Nationality Act, as amended. In the case of an
1107	1107	13 intercountry adoption that requires oversight by the adoption
1108	1108	14 services governed by the Intercountry Adoption Universal
1109	1109	15 Accreditation Act of 2012, this State shall not impose any
1110	1110	16 additional preadoption requirements.
1111	1111	17 (d) (Blank).
1112	1112	18 (e) Re-adoption after an intercountry adoption.
1113	1113	19 (1) Any time after a minor child has been adopted in a
1114	1114	20 foreign country and has immigrated to the United States,
1115	1115	21 the adoptive parent or parents of the child may petition
1116	1116	22 the court for a judgment of adoption to re-adopt the child
1117	1117	23 and confirm the foreign adoption decree.
1118	1118	24 (2) The petitioner must submit to the court one or
1119	1119	25 more of the following to verify the foreign adoption:
1120	1120	26 (i) an immigrant visa for the child issued by
1121	1121
1122	1122
1123	1123
1124	1124
1125	1125
1126	1126	HB3101 - 31 - LRB103 29344 KTG 55731 b
1127	1127
1128	1128
1129	1129	HB3101- 32 -LRB103 29344 KTG 55731 b HB3101 - 32 - LRB103 29344 KTG 55731 b
1130	1130	HB3101 - 32 - LRB103 29344 KTG 55731 b
1131	1131	1 United States Citizenship and Immigration Services of
1132	1132	2 the U.S. Department of Homeland Security that was
1133	1133	3 valid at the time of the child's immigration;
1134	1134	4 (ii) a decree, judgment, certificate of adoption,
1135	1135	5 adoption registration, or equivalent court order,
1136	1136	6 entered or issued by a court of competent jurisdiction
1137	1137	7 or administrative body outside the United States,
1138	1138	8 establishing the relationship of parent and child by
1139	1139	9 adoption; or
1140	1140	10 (iii) such other evidence deemed satisfactory by
1141	1141	11 the court.
1142	1142	12 (3) The child's immigrant visa shall be prima facie
1143	1143	13 proof that the adoption was established in accordance with
1144	1144	14 the laws of the foreign jurisdiction and met United States
1145	1145	15 requirements for immigration.
1146	1146	16 (4) If the petitioner submits documentation that
1147	1147	17 satisfies the requirements of paragraph (2), the court
1148	1148	18 shall not appoint a guardian ad litem for the minor who is
1149	1149	19 the subject of the proceeding, shall not require any
1150	1150	20 further termination of parental rights of the child's
1151	1151	21 biological parents, nor shall it require any home study,
1152	1152	22 investigation, post-placement visit, or background check
1153	1153	23 of the petitioner.
1154	1154	24 (5) The petition may include a request for change of
1155	1155	25 the child's name and any other request for specific relief
1156	1156	26 that is in the best interests of the child. The relief may
1157	1157
1158	1158
1159	1159
1160	1160
1161	1161
1162	1162	HB3101 - 32 - LRB103 29344 KTG 55731 b
1163	1163
1164	1164
1165	1165	HB3101- 33 -LRB103 29344 KTG 55731 b HB3101 - 33 - LRB103 29344 KTG 55731 b
1166	1166	HB3101 - 33 - LRB103 29344 KTG 55731 b
1167	1167	1 include a request for a revised birth date for the child if
1168	1168	2 supported by evidence from a medical or dental
1169	1169	3 professional attesting to the appropriate age of the child
1170	1170	4 or other collateral evidence.
1171	1171	5 (6) Two adoptive parents who adopted a minor child
1172	1172	6 together in a foreign country while married to one another
1173	1173	7 may file a petition for adoption to re-adopt the child
1174	1174	8 jointly, regardless of whether their marriage has been
1175	1175	9 dissolved. If either parent whose marriage was dissolved
1176	1176	10 has subsequently remarried or entered into a civil union
1177	1177	11 with another person, the new spouse or civil union partner
1178	1178	12 shall not join in the petition to re-adopt the child,
1179	1179	13 unless the new spouse or civil union partner is seeking to
1180	1180	14 adopt the child. If either adoptive parent does not join
1181	1181	15 in the petition, he or she must be joined as a party
1182	1182	16 defendant. The defendant parent's failure to participate
1183	1183	17 in the re-adoption proceeding shall not affect the
1184	1184	18 existing parental rights or obligations of the parent as
1185	1185	19 they relate to the minor child, and the parent's name
1186	1186	20 shall be placed on any subsequent birth record issued for
1187	1187	21 the child as a result of the re-adoption proceeding.
1188	1188	22 (7) An adoptive parent who adopted a minor child in a
1189	1189	23 foreign country as an unmarried person may file a petition
1190	1190	24 for adoption to re-adopt the child as a sole petitioner,
1191	1191	25 even if the adoptive parent has subsequently married or
1192	1192	26 entered into a civil union.
1193	1193
1194	1194
1195	1195
1196	1196
1197	1197
1198	1198	HB3101 - 33 - LRB103 29344 KTG 55731 b
1199	1199
1200	1200
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1202	1202	HB3101 - 34 - LRB103 29344 KTG 55731 b
1203	1203	1 (8) If one of the adoptive parents who adopted a minor
1204	1204	2 child dies prior to a re-adoption proceeding, the deceased
1205	1205	3 parent's name shall be placed on any subsequent birth
1206	1206	4 record issued for the child as a result of the re-adoption
1207	1207	5 proceeding.
1208	1208	6 (Source: P.A. 99-49, eff. 7-15-15; 100-344, eff. 8-25-17;
1209	1209	7 100-863, eff. 8-14-18.)
1210	1210	8 (750 ILCS 50/10) (from Ch. 40, par. 1512)
1211	1211	9 Sec. 10. Forms of consent and surrender; execution and
1212	1212	10 acknowledgment thereof.
1213	1213	11 A. The form of consent required for the adoption of a born
1214	1214	12 child shall be substantially as follows:
1215	1215	13 FINAL AND IRREVOCABLE CONSENT TO ADOPTION
1216	1216	14 I, ...., (relationship, e.g., mother, father, relative,
1217	1217	15 guardian) of ...., a male or female (circle one) child, state:
1218	1218	16 That such child was born on .... at ....
1219	1219	17 That I reside at ...., County of .... and State of ....
1220	1220	18 That I am of the age of .... years.
1221	1221	19 That I hereby enter my appearance in this proceeding and
1222	1222	20 waive service of summons on me.
1223	1223	21 That I hereby acknowledge that I have been provided with a
1224	1224	22 copy of the Birth Parent Rights and Responsibilities-Private
1225	1225	23 Form before signing this Consent and that I have had time to
1226	1226
1227	1227
1228	1228
1229	1229
1230	1230
1231	1231	HB3101 - 34 - LRB103 29344 KTG 55731 b
1232	1232
1233	1233
1234	1234	HB3101- 35 -LRB103 29344 KTG 55731 b HB3101 - 35 - LRB103 29344 KTG 55731 b
1235	1235	HB3101 - 35 - LRB103 29344 KTG 55731 b
1236	1236	1 read, or have had read to me, this Form. I understand that if I
1237	1237	2 do not receive any of the rights as described in this Form, it
1238	1238	3 shall not constitute a basis to revoke this Final and
1239	1239	4 Irrevocable Consent.
1240	1240	5 That I do hereby consent and agree to the adoption of such
1241	1241	6 child.
1242	1242	7 That I wish to and understand that by signing this consent
1243	1243	8 I do irrevocably and permanently give up all custody and other
1244	1244	9 parental rights I have to such child.
1245	1245	10 That I understand such child will be placed for adoption
1246	1246	11 and that I cannot under any circumstances, after signing this
1247	1247	12 document, change my mind and revoke or cancel this consent or
1248	1248	13 obtain or recover custody or any other rights over such child.
1249	1249	14 That I have read and understand the above and I am signing it
1250	1250	15 as my free and voluntary act.
1251	1251	16 Dated (insert date).
1252	1252	17 .........................
1253	1253	18 If under Section 8 the consent of more than one person is
1254	1254	19 required, then each such person shall execute a separate
1255	1255	20 consent.
1256	1256	21 A-1. (1) The form of the Final and Irrevocable Consent to
1257	1257	22 Adoption by a Specified Person or Persons: Non-DCFS Case set
1258	1258	23 forth in this subsection A-1 is to be used by legal parents
1259	1259	24 only. This form is not to be used in cases in which there is a
1260	1260	25 pending petition under Section 2-13 of the Juvenile Court Act
1261	1261
1262	1262
1263	1263
1264	1264
1265	1265
1266	1266	HB3101 - 35 - LRB103 29344 KTG 55731 b
1267	1267
1268	1268
1269	1269	HB3101- 36 -LRB103 29344 KTG 55731 b HB3101 - 36 - LRB103 29344 KTG 55731 b
1270	1270	HB3101 - 36 - LRB103 29344 KTG 55731 b
1271	1271	1 of 1987.
1272	1272	2 (2) The form of the Final and Irrevocable Consent to
1273	1273	3 Adoption by a Specified Person or Persons in a non-DCFS case
1274	1274	4 shall have the caption of the proceeding in which it is to be
1275	1275	5 filed and shall be substantially as follows:
1276	1276	6 FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY
1277	1277	7 A SPECIFIED PERSON OR PERSONS; NON-DCFS CASE
1278	1278	8 I, ...., (relationship, e.g., mother, father) of ...., a
1279	1279	9 male or female (circle one) child, state:
1280	1280	10 1. That such child was born on ...., at ....., in the
1281	1281	11 City/Town of ... and State of ....
1282	1282	12 2. That I reside at ...., County of .... and State of ....,
1283	1283	13 my email address (if I have one) is .... my cell phone number
1284	1284	14 where I can receive text messages (if I have one) is .... and
1285	1285	15 my land line phone number (if I have one) is ...., and any
1286	1286	16 other contact information is ....
1287	1287	17 3. That I am of the age of .... years.
1288	1288	18 4. That I hereby enter my appearance in this proceeding
1289	1289	19 and waive service of summons on me.
1290	1290	20 5. That I hereby acknowledge that I have been provided a
1291	1291	21 copy of the Birth Parent Rights and Responsibilities-Private
1292	1292	22 Form before signing this Consent and that I have had time to
1293	1293	23 read, or have had read to me, this Form and that I understand
1294	1294	24 the Rights and Responsibilities described in this Form. I
1295	1295
1296	1296
1297	1297
1298	1298
1299	1299
1300	1300	HB3101 - 36 - LRB103 29344 KTG 55731 b
1301	1301
1302	1302
1303	1303	HB3101- 37 -LRB103 29344 KTG 55731 b HB3101 - 37 - LRB103 29344 KTG 55731 b
1304	1304	HB3101 - 37 - LRB103 29344 KTG 55731 b
1305	1305	1 understand that if I do not receive any of my rights as
1306	1306	2 described in said Form, it shall not constitute a basis to
1307	1307	3 revoke this Final and Irrevocable Consent to Adoption by a
1308	1308	4 Specified Person.
1309	1309	5 6. That I do hereby consent and agree to the adoption of
1310	1310	6 such child by .... (specified person or persons) only. If only
1311	1311	7 first names are used for the specified person or persons, I
1312	1312	8 voluntarily sign this specified consent form without
1313	1313	9 disclosure to me of the last name of the specified person or
1314	1314	10 persons. However, I understand that if I wish to know the last
1315	1315	11 name of the specified person or persons, I may request it
1316	1316	12 before signing the form. If I do not receive the last name, I
1317	1317	13 may choose not to sign the specified consent form.
1318	1318	14 7. That I wish to and understand that upon signing this
1319	1319	15 consent I do irrevocably and permanently give up all custody
1320	1320	16 and other parental rights I have to such child if such child is
1321	1321	17 adopted by .... (specified person or persons). I hereby
1322	1322	18 transfer all of my rights to the custody, care and control of
1323	1323	19 such child to ............................. (specified person
1324	1324	20 or persons).
1325	1325	21 8. That I understand such child will be adopted by
1326	1326	22 ....................... (specified person or persons) and that
1327	1327	23 I cannot under any circumstances, after signing this document,
1328	1328	24 change my mind and revoke or cancel this consent or obtain or
1329	1329	25 recover custody or any other rights over such child if
1330	1330	26 ............................ (specified person or persons)
1331	1331
1332	1332
1333	1333
1334	1334
1335	1335
1336	1336	HB3101 - 37 - LRB103 29344 KTG 55731 b
1337	1337
1338	1338
1339	1339	HB3101- 38 -LRB103 29344 KTG 55731 b HB3101 - 38 - LRB103 29344 KTG 55731 b
1340	1340	HB3101 - 38 - LRB103 29344 KTG 55731 b
1341	1341	1 adopt(s) such child; PROVIDED that each specified person has
1342	1342	2 filed or shall file, within 60 days from the date hereof, a
1343	1343	3 petition for the adoption of such child.
1344	1344	4 9. That if the specified person or persons designated
1345	1345	5 herein do not file a petition for adoption within the
1346	1346	6 time-frame specified above, or, if said petition for adoption
1347	1347	7 is filed within the time-frame specified above but the
1348	1348	8 adoption petition is dismissed with prejudice or the adoption
1349	1349	9 proceeding is otherwise concluded without an order declaring
1350	1350	10 the child to be the adopted child of the specified person or
1351	1351	11 persons, then I understand that I will be sent written notice
1352	1352	12 of such circumstances at the mailing address, at the email
1353	1353	13 address, through a text message to my cell phone number, and to
1354	1354	14 any other contact information I have provided in paragraph 2
1355	1355	15 within 5 business days of this occurrence. I understand that
1356	1356	16 the notice will be directed to me using the contact
1357	1357	17 information I have provided in this consent. I understand that
1358	1358	18 I will have 15 business days from the date that the written
1359	1359	19 notice is sent to me to respond in the manner described in the
1360	1360	20 notice, within which time I may request the Court to declare
1361	1361	21 this consent voidable and return the child to me. I further
1362	1362	22 understand that the Court will make the final decision of
1363	1363	23 whether or not the child will be returned to me. If I do not
1364	1364	24 make such request within 15 business days of the date the
1365	1365	25 notice was sent, then I expressly waive any other notice or
1366	1366	26 service of process in any legal proceeding regarding the
1367	1367
1368	1368
1369	1369
1370	1370
1371	1371
1372	1372	HB3101 - 38 - LRB103 29344 KTG 55731 b
1373	1373
1374	1374
1375	1375	HB3101- 39 -LRB103 29344 KTG 55731 b HB3101 - 39 - LRB103 29344 KTG 55731 b
1376	1376	HB3101 - 39 - LRB103 29344 KTG 55731 b
1377	1377	1 child, including a legal proceeding for someone other than
1378	1378	2 ..... (specified person or persons) to adopt the child, and
1379	1379	3 that I will have no parental rights as to the child. The person
1380	1380	4 sending the notice shall file an affidavit of notice as proof
1381	1381	5 of the date sent.
1382	1382	6 10. That I expressly acknowledge that nothing in this
1383	1383	7 Consent impairs the validity and absolute finality of this
1384	1384	8 Consent under any circumstance other than those described in
1385	1385	9 paragraph 9 of this Consent.
1386	1386	10 11. That I understand that I have a remaining duty and
1387	1387	11 obligation to keep .............. (insert name and address of
1388	1388	12 the attorney for the specified person or persons) informed of
1389	1389	13 my current address or other preferred contact information
1390	1390	14 until this adoption has been finalized. My failure to do so may
1391	1391	15 result in the termination of my parental rights and the child
1392	1392	16 being placed for adoption in another home.
1393	1393	17 12. That I do expressly waive any other notice or service
1394	1394	18 of process in any of the legal proceedings for the adoption of
1395	1395	19 the child as long as the adoption proceeding by the specified
1396	1396	20 person or persons is pending.
1397	1397	21 13. That I have read and understand the above and I am
1398	1398	22 signing it as my free and voluntary act.
1399	1399	23 14. That I acknowledge that this consent is valid even if
1400	1400	24 the specified person or persons separate or divorce or one of
1401	1401	25 the specified persons dies prior to the entry of the final
1402	1402	26 judgment for adoption.
1403	1403
1404	1404
1405	1405
1406	1406
1407	1407
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1409	1409
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1413	1413	1 Dated (insert date).
1414	1414	2 .............................................
1415	1415	3 Signature of parent.
1416	1416	4 .............................................
1417	1417	5 Address of parent.
1418	1418	6 .............................................
1419	1419	7 Phone number(s) of parent.
1420	1420	8 .............................................
1421	1421	9 Personal email(s) of parent.
1422	1422	10 .............................................
1423	1423	11 (3) The form of the certificate of acknowledgement for a
1424	1424	12 Final and Irrevocable Consent for Adoption by a Specified
1425	1425	13 Person or Persons: Non-DCFS Case shall be substantially as
1426	1426	14 follows:
1427	1427	15 STATE OF ..............)
1428	1428	16 ) SS.
1429	1429	17 COUNTY OF .............)
1430	1430	18 I, .................... (Name of Judge or other person),
1431	1431	19 ..................... (official title, name, and address),
1432	1432	20 certify that ............., personally known to me to be the
1433	1433	21 same person whose name is subscribed to the foregoing Final
1434	1434	22 and Irrevocable Consent for Adoption by a Specified Person or
1435	1435	23 Persons; non-DCFS case, appeared before me this day in person
1436	1436	24 and acknowledged that (she)(he) signed and delivered the
1437	1437
1438	1438
1439	1439
1440	1440
1441	1441
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1443	1443
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1447	1447	1 consent as (her)(his) free and voluntary act, for the
1448	1448	2 specified purpose. I am further satisfied that, before signing
1449	1449	3 this Consent, ........ has read, or has had read to him or her,
1450	1450	4 the Birth Parent Rights and Responsibilities-Private Form.
1451	1451	5 A-2. Birth Parent Rights and Responsibilities-Private
1452	1452	6 Form. The Birth Parent Rights and Responsibilities-Private
1453	1453	7 Form must be read by, or have been read to, any person
1454	1454	8 executing a Final and Irrevocable Consent to Adoption under
1455	1455	9 subsection A, a Final and Irrevocable Consent to Adoption by a
1456	1456	10 Specified Person or Persons: Non-DCFS Case under subsection
1457	1457	11 A-1, or a Consent to Adoption of Unborn Child under subsection
1458	1458	12 B prior to the execution of said Consent. The form of the Birth
1459	1459	13 Parent Rights and Responsibilities-Private Form shall be
1460	1460	14 substantially as follows:
1461	1461	15 Birth Parent Rights and Responsibilities-Private Form
1462	1462	16 THIS FORM DOES NOT CONSTITUTE LEGAL ADVICE. LEGAL ADVICE IS
1463	1463	17 DEPENDENT ON THE SPECIFIC CIRCUMSTANCES OF EACH SITUATION AND
1464	1464	18 JURISDICTION. THE INFORMATION IN THIS FORM CANNOT REPLACE THE
1465	1465	19 ADVICE OF AN ATTORNEY LICENSED IN YOUR STATE.
1466	1466	20 As a birth parent in the State of Illinois, you have the
1467	1467	21 right:
1468	1468	22 1. To have your own attorney represent you. The
1469	1469	23 prospective adoptive parents may agree to pay for the cost of
1470	1470
1471	1471
1472	1472
1473	1473
1474	1474
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1476	1476
1477	1477
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1480	1480	1 your attorney in a manner consistent with Illinois law, but
1481	1481	2 they are not required to do so.
1482	1482	3 2. To be treated with dignity and respect at all times and
1483	1483	4 to make decisions free from coercion and pressure.
1484	1484	5 3. To request to receive counseling before and after
1485	1485	6 signing a Final and Irrevocable Consent to Adoption
1486	1486	7 ("Consent"), a Final and Irrevocable Consent to Adoption by a
1487	1487	8 Specified Person or Persons: Non-DCFS Case ("Specified
1488	1488	9 Consent"), or a Consent to Adoption of Unborn Child ("Unborn
1489	1489	10 Consent"). The prospective adoptive parents may agree to pay
1490	1490	11 for the cost of counseling in a manner consistent with
1491	1491	12 Illinois law, but they are not required to do so.
1492	1492	13 4. To ask to be involved in choosing your child's
1493	1493	14 prospective adoptive parents and to ask to meet them.
1494	1494	15 5. To ask your child's prospective adoptive parents any
1495	1495	16 questions that pertain to your decision to place your child
1496	1496	17 with them.
1497	1497	18 6. To see your child before signing a Consent or Specified
1498	1498	19 Consent if you are the custodial parent, and to request to see
1499	1499	20 your child if you are not the custodial parent.
1500	1500	21 7. To request contact with your child and/or the child's
1501	1501	22 prospective adoptive parents, with the understanding that any
1502	1502	23 promises regarding contact with your child or receipt of
1503	1503	24 information about the child after signing a Consent, Specified
1504	1504	25 Consent, or Unborn Consent cannot be enforced under Illinois
1505	1505	26 law.
1506	1506
1507	1507
1508	1508
1509	1509
1510	1510
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1512	1512
1513	1513
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1516	1516	1 8. To receive copies of all documents that you sign and
1517	1517	2 have those documents provided to you in your preferred
1518	1518	3 language.
1519	1519	4 9. To request that your identifying information remain
1520	1520	5 confidential, unless required otherwise by Illinois law or
1521	1521	6 court order, and to voluntarily share your medical,
1522	1522	7 background, and identifying information, including information
1523	1523	8 on the original birth certificate of your child. This can be
1524	1524	9 done through the Illinois Adoption Registry and Medical
1525	1525	10 Information Exchange or through completing the Birth Parent
1526	1526	11 Preference Form. Please visit http://dph.illinois.gov or
1527	1527	12 www.newillinoisadoptionlaw.com.
1528	1528	13 10. To access the Confidential Intermediary Program which
1529	1529	14 provides a way for a court appointed person to connect and/or
1530	1530	15 exchange information between adoptees, adoptive parents and
1531	1531	16 birth parents, and other biological family members, provided
1532	1532	17 in most cases that mutual consent is given. Please visit
1533	1533	18 www.ci-illinois.org or call (800) 526-9022(x29).
1534	1534	19 11. To work with an adoption agency or attorney of your
1535	1535	20 choice, or change said agency or attorney, provided you
1536	1536	21 promptly inform all of the parties currently involved.
1537	1537	22 12. To receive, upon request, a written list of any
1538	1538	23 promised support, financial or otherwise, from your attorney
1539	1539	24 or the attorney for your child's prospective adoptive parents.
1540	1540	25 13. To delay signing a Consent, Specified Consent, or
1541	1541	26 Unborn Consent if you are not ready to do so.
1542	1542
1543	1543
1544	1544
1545	1545
1546	1546
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1548	1548
1549	1549
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1551	1551	HB3101 - 44 - LRB103 29344 KTG 55731 b
1552	1552	1 14. To decline to sign a Consent, Specified Consent, or
1553	1553	2 Unborn Consent even if you have received financial support
1554	1554	3 from the prospective adoptive parents.
1555	1555	4 If you do not receive any of the rights described in this
1556	1556	5 Form, it shall not be a basis to revoke a Consent, Specified
1557	1557	6 Consent, or Unborn Consent.
1558	1558	7 As a Birth Parent in the State of Illinois, you have the
1559	1559	8 responsibility:
1560	1560	9 1. To carefully consider your reasons for choosing
1561	1561	10 adoption.
1562	1562	11 2. (Birth mothers only) To accurately complete an
1563	1563	12 Affidavit of Identification, which identifies the father of
1564	1564	13 the child when known, with the understanding that a birth
1565	1565	14 mother has a right to decline to identify the birth father.
1566	1566	15 3. To provide the necessary documentation regarding
1567	1567	16 financial need to make an appropriate determination of
1568	1568	17 reasonable pregnancy-related expenses.
1569	1569	18 4. To not accept financial support or reimbursement of
1570	1570	19 pregnancy related expenses simultaneously from more than one
1571	1571	20 source or if you are not pregnant, as doing so is a crime.
1572	1572	21 5. To voluntarily provide all known medical, background,
1573	1573	22 and family information about yourself and your immediate
1574	1574	23 family to your child's prospective adoptive parents or their
1575	1575	24 attorney. For the health of your child, you are strongly
1576	1576	25 encouraged, but not required, to do so as set forth on the
1577	1577	26 following form:
1578	1578
1579	1579
1580	1580
1581	1581
1582	1582
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1584	1584
1585	1585
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1587	1587	HB3101 - 45 - LRB103 29344 KTG 55731 b
1588	1588	1 Birth Parent Medical Information
1589	1589	2 The purpose of this form is to gather your health history,
1590	1590	3 genetic history, and social background information to share
1591	1591	4 with the adoptive parents. It is important the adoptive family
1592	1592	5 provide this information to the child's physician. It will
1593	1593	6 become a part of the child's medical and family history. This
1594	1594	7 form, in its entirety, will be given to the adoptive
1595	1595	8 parent(s).
1596	1596	9 The following information is true and complete to the best
1597	1597	10 of my knowledge and belief.
1598	1598	11 Birth parent name:
1599	1599	12 ......................................
1600	1600	13 Signature:
1601	1601	14 ..............................................
1602	1602	15 Date:....................................................
1603	1603	16 YES or NO (circle one) I agree to release my full name on
1604	1604	17 this form to the adoptive family. If NO is circled then the
1605	1605	18 birth parent's name shall be redacted on this form.
1606	1606	19 MOTHER'S PHYSICAL CHARACTERISTICS:
1607	1607	20 Eyes: ... Hair: .... Complexion: .... Height: ....
1608	1608	21 Weight: .... Body build: ..... Race: .....
1609	1609	22 Nationality/Descent: ....... Blood type: .... Rh factor: ....
1610	1610	23 Eye glasses or contact lenses? Yes /.../ No /.../
1611	1611	24 Right /.../ Left /.../ handed
1612	1612	25 Age: .... or Date of birth: ..... Religion: .................
1613	1613	26 Please list your highest education level, occupation,
1614	1614
1615	1615
1616	1616
1617	1617
1618	1618
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1620	1620
1621	1621
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1623	1623	HB3101 - 46 - LRB103 29344 KTG 55731 b
1624	1624	1 hobbies, interests, and talents:
1625	1625	2 ............................
1626	1626	3 Existence of any disabilities? Yes /.../ No /.../
1627	1627	4 If yes, explain:.............................................
1628	1628	5 If you have other children, list them below. Include any
1629	1629	6 children previously placed for adoption.
1630	1630	7 ....................
1631	1631	8 Describe your relationship with the birth father: .......
1632	1632	9 FATHER'S PHYSICAL CHARACTERISTICS:
1633	1633	10 Eyes: ... Hair: .... Complexion: .... Height: ....
1634	1634	11 Weight: .... Body build: ..... Race: .....
1635	1635	12 Nationality/Descent: ....... Blood type: .... Rh factor: ....
1636	1636	13 Eye glasses or contact lenses? Yes /.../ No /.../
1637	1637	14 Right /.../ Left /.../ handed
1638	1638	15 Age: .... or Date of birth: ..... Religion: .................
1639	1639	16 Please list your highest education level, occupation,
1640	1640	17 hobbies, interests, and talents:
1641	1641	18 ............................
1642	1642	19 Existence of any disabilities? Yes /.../ No /.../
1643	1643	20 If yes, explain:.............................................
1644	1644	21 If you have other children, list them below. Include any
1645	1645	22 children previously placed for adoption.
1646	1646	23 ....................
1647	1647	24 PREGNANCY HISTORY INVOLVING THIS CHILD
1648	1648	25 Month prenatal care began during this pregnancy:.........
1649	1649	26 Complications during pregnancy: Yes ... No ... If yes,
1650	1650
1651	1651
1652	1652
1653	1653
1654	1654
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1656	1656
1657	1657
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1659	1659	HB3101 - 47 - LRB103 29344 KTG 55731 b
1660	1660	1 explain: ....................................................
1661	1661	2 .............................................................
1662	1662	3 MEDICATION AND OTHER SUBSTANCES USED DURING
1663	1663	4 PREGNANCY OR YEAR PRIOR TO PREGNANCY
1664	1664	5FREQUENCY/ FREQUENCY/ 6AMOUNT AMOUNT 7DURING PRIOR TO 8YES NO PREGNANCY PREGNANCY 9Alcohol/../ /../................. ...............10Amphetamines/../ /../................................11Barbiturates/../ /../................................12Cocaine/../ /../................................13Heroin/../ /../................................14LSD/../ /../................................15Marijuana/../ /../ ................. ............... 16Caffeine17(Coffee,18tea, etc)/../ /../ ................................19Prescription20drugs/../ /../ ................. ............... 21Non-22prescription 23drugs /../ /../................................24Other /../ /../ ................. ............... 5 FREQUENCY/ FREQUENCY/ 6 AMOUNT AMOUNT 7 DURING PRIOR TO 8 YES NO PREGNANCY PREGNANCY 9 Alcohol /../ /../ ................. ............... 10 Amphetamines /../ /../ ................. ............... 11 Barbiturates /../ /../ ................. ............... 12 Cocaine /../ /../ ................. ............... 13 Heroin /../ /../ ................. ............... 14 LSD /../ /../ ................. ............... 15 Marijuana /../ /../ ................. ............... 16 Caffeine 17 (Coffee, 18 tea, etc) /../ /../ ................. ............... 19 Prescription 20 drugs /../ /../ ................. ............... 21 Non- 22 prescription 23 drugs /../ /../ ................. ............... 24 Other /../ /../ ................. ...............
1665	1665	5 FREQUENCY/ FREQUENCY/
1666	1666	6 AMOUNT AMOUNT
1667	1667	7 DURING PRIOR TO
1668	1668	8 YES NO PREGNANCY PREGNANCY
1669	1669	9 Alcohol /../ /../ ................. ...............
1670	1670	10 Amphetamines /../ /../ ................. ...............
1671	1671	11 Barbiturates /../ /../ ................. ...............
1672	1672	12 Cocaine /../ /../ ................. ...............
1673	1673	13 Heroin /../ /../ ................. ...............
1674	1674	14 LSD /../ /../ ................. ...............
1675	1675	15 Marijuana /../ /../ ................. ...............
1676	1676	16 Caffeine
1677	1677	17 (Coffee,
1678	1678	18 tea, etc) /../ /../ ................. ...............
1679	1679	19 Prescription
1680	1680	20 drugs /../ /../ ................. ...............
1681	1681	21 Non-
1682	1682	22 prescription
1683	1683	23 drugs /../ /../ ................. ...............
1684	1684	24 Other /../ /../ ................. ...............
1685	1685	25 In addition to this form, a birth parent shall also be
1686	1686
1687	1687
1688	1688
1689	1689
1690	1690
1691	1691	HB3101 - 47 - LRB103 29344 KTG 55731 b
1692	1692
1693	1693
1694	1694	5 FREQUENCY/ FREQUENCY/
1695	1695	6 AMOUNT AMOUNT
1696	1696	7 DURING PRIOR TO
1697	1697	8 YES NO PREGNANCY PREGNANCY
1698	1698	9 Alcohol /../ /../ ................. ...............
1699	1699	10 Amphetamines /../ /../ ................. ...............
1700	1700	11 Barbiturates /../ /../ ................. ...............
1701	1701	12 Cocaine /../ /../ ................. ...............
1702	1702	13 Heroin /../ /../ ................. ...............
1703	1703	14 LSD /../ /../ ................. ...............
1704	1704	15 Marijuana /../ /../ ................. ...............
1705	1705	16 Caffeine
1706	1706	17 (Coffee,
1707	1707	18 tea, etc) /../ /../ ................. ...............
1708	1708	19 Prescription
1709	1709	20 drugs /../ /../ ................. ...............
1710	1710	21 Non-
1711	1711	22 prescription
1712	1712	23 drugs /../ /../ ................. ...............
1713	1713	24 Other /../ /../ ................. ...............
1714	1714
1715	1715
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1717	1717	HB3101 - 48 - LRB103 29344 KTG 55731 b
1718	1718	1 provided the forms for the Illinois Adoption Registry and
1719	1719	2 Medical Information Exchange.
1720	1720	3 B. The form of consent required for the adoption of an
1721	1721	4 unborn child shall be substantially as follows:
1722	1722	5 CONSENT TO ADOPTION OF UNBORN CHILD
1723	1723	6 I, ...., state:
1724	1724	7 That I am the father of a child expected to be born on or
1725	1725	8 about .... to .... (name of mother).
1726	1726	9 That I reside at .... County of ...., and State of .....
1727	1727	10 That I am of the age of .... years.
1728	1728	11 That I hereby enter my appearance in such adoption
1729	1729	12 proceeding and waive service of summons on me.
1730	1730	13 That I hereby acknowledge that I have been provided with a
1731	1731	14 copy of the Birth Parent Rights and Responsibilities-Private
1732	1732	15 Form before signing this Consent, and that I have had time to
1733	1733	16 read, or have had read to me, this Form. I understand that if I
1734	1734	17 do not receive any of the rights as described in this Form, it
1735	1735	18 shall not constitute a basis to revoke this Consent to
1736	1736	19 Adoption of Unborn Child.
1737	1737	20 That I do hereby consent and agree to the adoption of such
1738	1738	21 child, and that I have not previously executed a consent or
1739	1739	22 surrender with respect to such child.
1740	1740	23 That I wish to and do understand that by signing this
1741	1741	24 consent I do irrevocably and permanently give up all custody
1742	1742
1743	1743
1744	1744
1745	1745
1746	1746
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1748	1748
1749	1749
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1751	1751	HB3101 - 49 - LRB103 29344 KTG 55731 b
1752	1752	1 and other parental rights I have to such child, except that I
1753	1753	2 have the right to revoke this consent by giving written notice
1754	1754	3 of my revocation not later than 72 hours after the birth of the
1755	1755	4 child.
1756	1756	5 That I understand such child will be placed for adoption
1757	1757	6 and that, except as hereinabove provided, I cannot under any
1758	1758	7 circumstances, after signing this document, change my mind and
1759	1759	8 revoke or cancel this consent or obtain or recover custody or
1760	1760	9 any other rights over such child.
1761	1761	10 That I have read and understand the above and I am signing
1762	1762	11 it as my free and voluntary act.
1763	1763	12 Dated (insert date).
1764	1764	13 ........................
1765	1765	14 B-5. (1) The parent of a child may execute a consent to
1766	1766	15 standby adoption by a specified person or persons. A consent
1767	1767	16 under this subsection B-5 shall be acknowledged by a parent
1768	1768	17 pursuant to subsection H and subsection K of this Section. The
1769	1769	18 form of consent required for the standby adoption of a born
1770	1770	19 child effective at a future date when the consenting parent of
1771	1771	20 the child dies or requests that a final judgment of adoption be
1772	1772	21 entered shall be substantially as follows:
1773	1773	22 FINAL AND IRREVOCABLE CONSENT
1774	1774	23 TO STANDBY ADOPTION
1775	1775
1776	1776
1777	1777
1778	1778
1779	1779
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1781	1781
1782	1782
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1785	1785	1 I, ..., (relationship, e.g. mother or father) of ...., a
1786	1786	2 male or female (circle one) child, state:
1787	1787	3 That the child was born on .... at .....
1788	1788	4 That I reside at ...., County of ...., and State of .....
1789	1789	5 That I am of the age of .... years.
1790	1790	6 That I hereby enter my appearance in this proceeding and
1791	1791	7 waive service of summons on me in this action only.
1792	1792	8 That I do hereby consent and agree to the standby adoption
1793	1793	9 of the child, and that I have not previously executed a consent
1794	1794	10 or surrender with respect to the child.
1795	1795	11 That I wish to and understand that by signing this consent
1796	1796	12 I do irrevocably and permanently give up all custody and other
1797	1797	13 parental rights I have to the child, effective upon (my death)
1798	1798	14 (the child's other parent's death) or upon (my) (the other
1799	1799	15 parent's) request for the entry of a final judgment for
1800	1800	16 adoption if ..... (specified person or persons) adopt my
1801	1801	17 child.
1802	1802	18 That I understand that until (I die) (the child's other
1803	1803	19 parent dies), I retain all legal rights and obligations
1804	1804	20 concerning the child, but at that time, I irrevocably give all
1805	1805	21 custody and other parental rights to .... (specified person or
1806	1806	22 persons).
1807	1807	23 I understand my child will be adopted by .......
1808	1808	24 (specified person or persons) only and that I cannot, under
1809	1809	25 any circumstances, after signing this document, change my mind
1810	1810	26 and revoke or cancel this consent or obtain or recover custody
1811	1811
1812	1812
1813	1813
1814	1814
1815	1815
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1817	1817
1818	1818
1819	1819	HB3101- 51 -LRB103 29344 KTG 55731 b HB3101 - 51 - LRB103 29344 KTG 55731 b
1820	1820	HB3101 - 51 - LRB103 29344 KTG 55731 b
1821	1821	1 or any other rights over my child if ..... (specified person or
1822	1822	2 persons) adopt my child.
1823	1823	3 I understand that this consent to standby adoption is
1824	1824	4 valid only if the petition for standby adoption is filed and
1825	1825	5 that if ....... (specified person or persons), for any reason,
1826	1826	6 cannot or will not file a petition for standby adoption or if
1827	1827	7 his, her, or their petition for standby adoption is denied,
1828	1828	8 then this consent is void. I have the right to notice of any
1829	1829	9 other proceeding that could affect my parental rights.
1830	1830	10 That I have read and understand the above and I am signing
1831	1831	11 it as my free and voluntary act.
1832	1832	12 Dated (insert date).
1833	1833	13 ....................
1834	1834	14 If under Section 8 the consent of more than one person is
1835	1835	15 required, then each such person shall execute a separate
1836	1836	16 consent. A separate consent shall be executed for each child.
1837	1837	17 (2) If the parent consents to a standby adoption by 2
1838	1838	18 specified persons, then the form shall contain 2 additional
1839	1839	19 paragraphs in substantially the following form:
1840	1840	20 If .... (specified persons) obtain a judgment of
1841	1841	21 dissolution of marriage before the judgment for adoption is
1842	1842	22 entered, then ..... (specified person) shall adopt my child. I
1843	1843	23 understand that I cannot change my mind and revoke this
1844	1844	24 consent or obtain or recover custody of my child if .....
1845	1845	25 (specified persons) obtain a judgment of dissolution of
1846	1846
1847	1847
1848	1848
1849	1849
1850	1850
1851	1851	HB3101 - 51 - LRB103 29344 KTG 55731 b
1852	1852
1853	1853
1854	1854	HB3101- 52 -LRB103 29344 KTG 55731 b HB3101 - 52 - LRB103 29344 KTG 55731 b
1855	1855	HB3101 - 52 - LRB103 29344 KTG 55731 b
1856	1856	1 marriage and ..... (specified person) adopts my child. I
1857	1857	2 understand that I cannot change my mind and revoke this
1858	1858	3 consent if ...... (specified persons) obtain a judgment of
1859	1859	4 dissolution of marriage before the adoption is final. I
1860	1860	5 understand that this consent to adoption has no effect on who
1861	1861	6 will get custody of my child if ..... (specified persons)
1862	1862	7 obtain a judgment of dissolution of marriage after the
1863	1863	8 adoption is final. I understand that if either .....
1864	1864	9 (specified persons) dies before the petition to adopt my child
1865	1865	10 is granted, then the surviving person may adopt my child. I
1866	1866	11 understand that I cannot change my mind and revoke this
1867	1867	12 consent or obtain or recover custody of my child if the
1868	1868	13 surviving person adopts my child.
1869	1869	14 A consent to standby adoption by specified persons on this
1870	1870	15 form shall have no effect on a court's determination of
1871	1871	16 custody or visitation under the Illinois Marriage and
1872	1872	17 Dissolution of Marriage Act if the marriage of the specified
1873	1873	18 persons is dissolved before the adoption is final.
1874	1874	19 (3) The form of the certificate of acknowledgement for a
1875	1875	20 Final and Irrevocable Consent for Standby Adoption shall be
1876	1876	21 substantially as follows:
1877	1877	22 STATE OF .....)
1878	1878	23 ) SS.
1879	1879	24 COUNTY OF ....)
1880	1880
1881	1881
1882	1882
1883	1883
1884	1884
1885	1885	HB3101 - 52 - LRB103 29344 KTG 55731 b
1886	1886
1887	1887
1888	1888	HB3101- 53 -LRB103 29344 KTG 55731 b HB3101 - 53 - LRB103 29344 KTG 55731 b
1889	1889	HB3101 - 53 - LRB103 29344 KTG 55731 b
1890	1890	1 I, ....... (name of Judge or other person) ..... (official
1891	1891	2 title, name, and address), certify that ......., personally
1892	1892	3 known to me to be the same person whose name is subscribed to
1893	1893	4 the foregoing Final and Irrevocable Consent to Standby
1894	1894	5 Adoption, appeared before me this day in person and
1895	1895	6 acknowledged that (she) (he) signed and delivered the consent
1896	1896	7 as (her) (his) free and voluntary act, for the specified
1897	1897	8 purpose.
1898	1898	9 I have fully explained that this consent to adoption is
1899	1899	10 valid only if the petition to adopt is filed, and that if the
1900	1900	11 specified person or persons, for any reason, cannot or will
1901	1901	12 not adopt the child or if the adoption petition is denied, then
1902	1902	13 this consent will be void. I have fully explained that if the
1903	1903	14 specified person or persons adopt the child, by signing this
1904	1904	15 consent (she) (he) is irrevocably and permanently
1905	1905	16 relinquishing all parental rights to the child, and (she) (he)
1906	1906	17 has stated that such is (her) (his) intention and desire.
1907	1907	18 Dated (insert date).
1908	1908	19 Signature ..............................
1909	1909	20 (4) If a consent to standby adoption is executed in this
1910	1910	21 form, the consent shall be valid only if the specified person
1911	1911	22 or persons adopt the child. The consent shall be void if:
1912	1912	23 (a) the specified person or persons do not file a
1913	1913	24 petition for standby adoption of the child; or
1914	1914	25 (b) a court denies the standby adoption petition.
1915	1915
1916	1916
1917	1917
1918	1918
1919	1919
1920	1920	HB3101 - 53 - LRB103 29344 KTG 55731 b
1921	1921
1922	1922
1923	1923	HB3101- 54 -LRB103 29344 KTG 55731 b HB3101 - 54 - LRB103 29344 KTG 55731 b
1924	1924	HB3101 - 54 - LRB103 29344 KTG 55731 b
1925	1925	1 The parent shall not need to take further action to revoke
1926	1926	2 the consent if the standby adoption by the specified person or
1927	1927	3 persons does not occur, notwithstanding the provisions of
1928	1928	4 Section 11 of this Act.
1929	1929	5 C. The form of surrender to any agency given by a parent of
1930	1930	6 a born child who is to be subsequently placed for adoption
1931	1931	7 shall be substantially as follows and shall contain such other
1932	1932	8 facts and statements as the particular agency shall require.
1933	1933	9 FINAL AND IRREVOCABLE SURRENDER
1934	1934	10 FOR PURPOSES OF ADOPTION
1935	1935	11 I, .... (relationship, e.g., mother, father, relative,
1936	1936	12 guardian) of ...., a male or female (circle one) child, state:
1937	1937	13 That such child was born on ...., at .....
1938	1938	14 That I reside at ...., County of ...., and State of .....
1939	1939	15 That I am of the age of .... years.
1940	1940	16 That I do hereby surrender and entrust the entire custody
1941	1941	17 and control of such child to the .... (the "Agency"), a
1942	1942	18 (public) (licensed) child welfare agency with its principal
1943	1943	19 office in the City of ...., County of .... and State of ....,
1944	1944	20 for the purpose of enabling it to care for and supervise the
1945	1945	21 care of such child, to place such child for adoption and to
1946	1946	22 consent to the legal adoption of such child.
1947	1947	23 That I hereby grant to the Agency full power and authority
1948	1948	24 to place such child with any person or persons it may in its
1949	1949
1950	1950
1951	1951
1952	1952
1953	1953
1954	1954	HB3101 - 54 - LRB103 29344 KTG 55731 b
1955	1955
1956	1956
1957	1957	HB3101- 55 -LRB103 29344 KTG 55731 b HB3101 - 55 - LRB103 29344 KTG 55731 b
1958	1958	HB3101 - 55 - LRB103 29344 KTG 55731 b
1959	1959	1 sole discretion select to become the adopting parent or
1960	1960	2 parents and to consent to the legal adoption of such child by
1961	1961	3 such person or persons; and to take any and all measures which,
1962	1962	4 in the judgment of the Agency, may be for the best interests of
1963	1963	5 such child, including authorizing medical, surgical and dental
1964	1964	6 care and treatment including inoculation and anaesthesia for
1965	1965	7 such child.
1966	1966	8 That I wish to and understand that by signing this
1967	1967	9 surrender I do irrevocably and permanently give up all custody
1968	1968	10 and other parental rights I have to such child.
1969	1969	11 That I understand I cannot under any circumstances, after
1970	1970	12 signing this surrender, change my mind and revoke or cancel
1971	1971	13 this surrender or obtain or recover custody or any other
1972	1972	14 rights over such child.
1973	1973	15 That I have read and understand the above and I am signing
1974	1974	16 it as my free and voluntary act.
1975	1975	17 Dated (insert date).
1976	1976	18 ........................
1977	1977	19 C-5. The form of a Final and Irrevocable Designated
1978	1978	20 Surrender for Purposes of Adoption to any agency given by a
1979	1979	21 parent of a born child who is to be subsequently placed for
1980	1980	22 adoption is to be used by legal parents only. The form shall be
1981	1981	23 substantially as follows and shall contain such other facts
1982	1982	24 and statements as the particular agency shall require:
1983	1983
1984	1984
1985	1985
1986	1986
1987	1987
1988	1988	HB3101 - 55 - LRB103 29344 KTG 55731 b
1989	1989
1990	1990
1991	1991	HB3101- 56 -LRB103 29344 KTG 55731 b HB3101 - 56 - LRB103 29344 KTG 55731 b
1992	1992	HB3101 - 56 - LRB103 29344 KTG 55731 b
1993	1993	1 FINAL AND IRREVOCABLE DESIGNATED SURRENDER
1994	1994	2 FOR PURPOSES OF ADOPTION
1995	1995	3 I, .... (relationship, e.g., mother, father, relative,
1996	1996	4 guardian) of ...., a male or female (circle one) child, state:
1997	1997	5 1. That such child was born on ...., at .....
1998	1998	6 2. That I reside at ...., County of ...., and State of
1999	1999	7 ....., my email address (if I have one) is .... my cell phone
2000	2000	8 number where I can receive text messages (if I have one) is
2001	2001	9 .... and my land line phone number (if I have one) is ...., and
2002	2002	10 any other contact information is ....
2003	2003	11 3. That I am of the age of .... years.
2004	2004	12 4. That I do hereby surrender and entrust the entire
2005	2005	13 custody and control of such child to the .... (the "Agency"), a
2006	2006	14 (public) (licensed) child welfare agency with its principal
2007	2007	15 office in the City of ...., County of .... and State of ....,
2008	2008	16 for the purpose of enabling it to care for and supervise the
2009	2009	17 care of such child, to place such child for adoption with
2010	2010	18 ............................. (specified person or persons)
2011	2011	19 and to consent to the legal adoption of such child and to take
2012	2012	20 any and all measures which, in the judgment of the Agency, may
2013	2013	21 be for the best interests of such child, including authorizing
2014	2014	22 medical, surgical and dental care and treatment including
2015	2015	23 inoculation and anesthesia for such child. If only first names
2016	2016	24 are used for the specified person or persons, I voluntarily
2017	2017	25 sign this designated surrender without disclosure to me of the
2018	2018
2019	2019
2020	2020
2021	2021
2022	2022
2023	2023	HB3101 - 56 - LRB103 29344 KTG 55731 b
2024	2024
2025	2025
2026	2026	HB3101- 57 -LRB103 29344 KTG 55731 b HB3101 - 57 - LRB103 29344 KTG 55731 b
2027	2027	HB3101 - 57 - LRB103 29344 KTG 55731 b
2028	2028	1 last name of the specified person or persons. However, I
2029	2029	2 understand that if I wish to know the last name of the
2030	2030	3 specified person or persons, I may request it before signing
2031	2031	4 the form. If I do not receive the last name, I may choose not
2032	2032	5 to sign the designated surrender form.
2033	2033	6 5. That I wish to and understand that by signing this
2034	2034	7 surrender I do irrevocably and permanently give up all custody
2035	2035	8 and other parental rights I have to such child.
2036	2036	9 6. That if the petition for adoption is not filed by the
2037	2037	10 specified person or persons designated herein or, if the
2038	2038	11 petition for adoption is filed but the adoption petition is
2039	2039	12 dismissed with prejudice or the adoption proceeding is
2040	2040	13 otherwise concluded without an order declaring the child to be
2041	2041	14 the adopted child of each specified person, then I understand
2042	2042	15 that the Agency will send notice to me at the mailing address,
2043	2043	16 at the email address, through a text message to my cell phone
2044	2044	17 number provided in paragraph 2, and to any other contact
2045	2045	18 information I have provided in paragraph 2 within 5 business
2046	2046	19 days of this occurrence. The person sending the notice shall
2047	2047	20 prepare an affidavit of notice. I understand that I will have
2048	2048	21 15 business days from the date that the written notice was sent
2049	2049	22 to respond, within which time I may choose to designate other
2050	2050	23 adoptive parent(s). However, I acknowledge that the Agency has
2051	2051	24 full power and authority to place the child for adoption with
2052	2052	25 any person or persons it may in its sole discretion select to
2053	2053	26 become the adopting parent or parents and to consent to the
2054	2054
2055	2055
2056	2056
2057	2057
2058	2058
2059	2059	HB3101 - 57 - LRB103 29344 KTG 55731 b
2060	2060
2061	2061
2062	2062	HB3101- 58 -LRB103 29344 KTG 55731 b HB3101 - 58 - LRB103 29344 KTG 55731 b
2063	2063	HB3101 - 58 - LRB103 29344 KTG 55731 b
2064	2064	1 legal adoption of the child by such person or persons.
2065	2065	2 7. That I acknowledge that this surrender is valid even if
2066	2066	3 the specified persons separate or divorce or one of the
2067	2067	4 specified persons dies prior to the entry of the final
2068	2068	5 judgment for adoption.
2069	2069	6 8. That I expressly acknowledge that the above paragraphs
2070	2070	7 6 and 7 do not impair the validity and absolute finality of
2071	2071	8 this surrender under any circumstance.
2072	2072	9 9. That I understand that I have a remaining obligation to
2073	2073	10 keep the Agency informed of my current contact information
2074	2074	11 until the adoption of the child has been finalized if I wish to
2075	2075	12 be notified in the event the adoption by the specified
2076	2076	13 person(s) cannot proceed.
2077	2077	14 10. That I understand I cannot under any circumstances,
2078	2078	15 after signing this surrender, change my mind and revoke or
2079	2079	16 cancel this surrender or obtain or recover custody or any
2080	2080	17 other rights over such child.
2081	2081	18 11. That I have read and understand the above and I am
2082	2082	19 signing it as my free and voluntary act.
2083	2083	20 Dated (insert date).
2084	2084	21 ..............................
2085	2085	22 D. The form of surrender to an agency given by a parent of
2086	2086	23 an unborn child who is to be subsequently placed for adoption
2087	2087	24 shall be substantially as follows and shall contain such other
2088	2088	25 facts and statements as the particular agency shall require.
2089	2089
2090	2090
2091	2091
2092	2092
2093	2093
2094	2094	HB3101 - 58 - LRB103 29344 KTG 55731 b
2095	2095
2096	2096
2097	2097	HB3101- 59 -LRB103 29344 KTG 55731 b HB3101 - 59 - LRB103 29344 KTG 55731 b
2098	2098	HB3101 - 59 - LRB103 29344 KTG 55731 b
2099	2099	1 SURRENDER OF UNBORN CHILD FOR
2100	2100	2 PURPOSES OF ADOPTION
2101	2101	3 I, .... (father), state:
2102	2102	4 That I am the father of a child expected to be born on or
2103	2103	5 about .... to .... (name of mother).
2104	2104	6 That I reside at ...., County of ...., and State of .....
2105	2105	7 That I am of the age of .... years.
2106	2106	8 That I do hereby surrender and entrust the entire custody
2107	2107	9 and control of such child to the .... (the "Agency"), a
2108	2108	10 (public) (licensed) child welfare agency with its principal
2109	2109	11 office in the City of ...., County of .... and State of ....,
2110	2110	12 for the purpose of enabling it to care for and supervise the
2111	2111	13 care of such child, to place such child for adoption and to
2112	2112	14 consent to the legal adoption of such child, and that I have
2113	2113	15 not previously executed a consent or surrender with respect to
2114	2114	16 such child.
2115	2115	17 That I hereby grant to the Agency full power and authority
2116	2116	18 to place such child with any person or persons it may in its
2117	2117	19 sole discretion select to become the adopting parent or
2118	2118	20 parents and to consent to the legal adoption of such child by
2119	2119	21 such person or persons; and to take any and all measures which,
2120	2120	22 in the judgment of the Agency, may be for the best interests of
2121	2121	23 such child, including authorizing medical, surgical and dental
2122	2122	24 care and treatment, including inoculation and anaesthesia for
2123	2123
2124	2124
2125	2125
2126	2126
2127	2127
2128	2128	HB3101 - 59 - LRB103 29344 KTG 55731 b
2129	2129
2130	2130
2131	2131	HB3101- 60 -LRB103 29344 KTG 55731 b HB3101 - 60 - LRB103 29344 KTG 55731 b
2132	2132	HB3101 - 60 - LRB103 29344 KTG 55731 b
2133	2133	1 such child.
2134	2134	2 That I wish to and understand that by signing this
2135	2135	3 surrender I do irrevocably and permanently give up all custody
2136	2136	4 and other parental rights I have to such child.
2137	2137	5 That I understand I cannot under any circumstances, after
2138	2138	6 signing this surrender, change my mind and revoke or cancel
2139	2139	7 this surrender or obtain or recover custody or any other
2140	2140	8 rights over such child, except that I have the right to revoke
2141	2141	9 this surrender by giving written notice of my revocation not
2142	2142	10 later than 72 hours after the birth of such child.
2143	2143	11 That I have read and understand the above and I am signing
2144	2144	12 it as my free and voluntary act.
2145	2145	13 Dated (insert date).
2146	2146	14 ........................
2147	2147	15 E. The form of consent required from the parents for the
2148	2148	16 adoption of an adult, when such adult elects to obtain such
2149	2149	17 consent, shall be substantially as follows:
2150	2150	18 CONSENT
2151	2151	19 I, ...., (father) (mother) of ...., an adult, state:
2152	2152	20 That I reside at ...., County of .... and State of .....
2153	2153	21 That I do hereby consent and agree to the adoption of such
2154	2154	22 adult by .... and .....
2155	2155	23 Dated (insert date).
2156	2156
2157	2157
2158	2158
2159	2159
2160	2160
2161	2161	HB3101 - 60 - LRB103 29344 KTG 55731 b
2162	2162
2163	2163
2164	2164	HB3101- 61 -LRB103 29344 KTG 55731 b HB3101 - 61 - LRB103 29344 KTG 55731 b
2165	2165	HB3101 - 61 - LRB103 29344 KTG 55731 b
2166	2166	1 .........................
2167	2167	2 F. The form of consent required for the adoption of a child
2168	2168	3 of the age of 14 years or over, or of an adult, to be given by
2169	2169	4 such person, shall be substantially as follows:
2170	2170	5 CONSENT
2171	2171	6 I, ...., state:
2172	2172	7 That I reside at ...., County of .... and State of .....
2173	2173	8 That I am of the age of .... years. That I hereby enter my
2174	2174	9 appearance in this proceeding and waive service of summons on
2175	2175	10 me. That I consent and agree to my adoption by .... and .....
2176	2176	11 Dated (insert date).
2177	2177	12 ........................
2178	2178	13 G. The form of consent given by an agency to the adoption
2179	2179	14 by specified persons of a child previously surrendered to it
2180	2180	15 shall set forth that the agency has the authority to execute
2181	2181	16 such consent. The form of consent given by a guardian of the
2182	2182	17 person of a child sought to be adopted, appointed by a court of
2183	2183	18 competent jurisdiction, shall set forth the facts of such
2184	2184	19 appointment and the authority of the guardian to execute such
2185	2185	20 consent.
2186	2186	21 H. A consent (other than that given by an agency, or
2187	2187	22 guardian of the person of the child sought to be adopted who
2188	2188
2189	2189
2190	2190
2191	2191
2192	2192
2193	2193	HB3101 - 61 - LRB103 29344 KTG 55731 b
2194	2194
2195	2195
2196	2196	HB3101- 62 -LRB103 29344 KTG 55731 b HB3101 - 62 - LRB103 29344 KTG 55731 b
2197	2197	HB3101 - 62 - LRB103 29344 KTG 55731 b
2198	2198	1 was appointed by a court of competent jurisdiction) shall be
2199	2199	2 acknowledged by a parent before a judge of a court of competent
2200	2200	3 jurisdiction or, except as otherwise provided in this Act,
2201	2201	4 before a representative of an agency, or before a person,
2202	2202	5 other than the attorney for the prospective adoptive parent or
2203	2203	6 parents, designated by a court of competent jurisdiction.
2204	2204	7 I. A surrender, or any other document equivalent to a
2205	2205	8 surrender, by which a child is surrendered to an agency shall
2206	2206	9 be acknowledged by the person signing such surrender, or other
2207	2207	10 document, before a judge of a court of competent jurisdiction,
2208	2208	11 or, except as otherwise provided in this Act, before a
2209	2209	12 representative of an agency, or before a person designated by
2210	2210	13 a court of competent jurisdiction.
2211	2211	14 J. The form of the certificate of acknowledgment for a
2212	2212	15 consent, a surrender, or any other document equivalent to a
2213	2213	16 surrender, shall be substantially as follows:
2214	2214	17 STATE OF ....)
2215	2215	18 ) SS.
2216	2216	19 COUNTY OF ...)
2217	2217	20 I, .... (Name of judge or other person), .... (official
2218	2218	21 title, name and location of court or status or position of
2219	2219	22 other person), certify that ...., personally known to me to be
2220	2220	23 the same person whose name is subscribed to the foregoing
2221	2221	24 (consent) (surrender), appeared before me this day in person
2222	2222	25 and acknowledged that (she) (he) signed and delivered such
2223	2223
2224	2224
2225	2225
2226	2226
2227	2227
2228	2228	HB3101 - 62 - LRB103 29344 KTG 55731 b
2229	2229
2230	2230
2231	2231	HB3101- 63 -LRB103 29344 KTG 55731 b HB3101 - 63 - LRB103 29344 KTG 55731 b
2232	2232	HB3101 - 63 - LRB103 29344 KTG 55731 b
2233	2233	1 (consent) (surrender) as (her) (his) free and voluntary act,
2234	2234	2 for the specified purpose.
2235	2235	3 I have fully explained that by signing such (consent)
2236	2236	4 (surrender) (she) (he) is irrevocably relinquishing all
2237	2237	5 parental rights to such child or adult and (she) (he) has
2238	2238	6 stated that such is (her) (his) intention and desire. (Add if
2239	2239	7 Consent only) I am further satisfied that, before signing this
2240	2240	8 Consent, ........ has read, or has had read to him or her, the
2241	2241	9 Birth Parent Rights and Responsibilities-Private Form.
2242	2242	10 Dated (insert date).
2243	2243	11 Signature ...............
2244	2244	12 K. When the execution of a consent or a surrender is
2245	2245	13 acknowledged before someone other than a judge, such other
2246	2246	14 person shall have his or her signature on the certificate
2247	2247	15 acknowledged before a notary public, in form substantially as
2248	2248	16 follows:
2249	2249	17 STATE OF ....)
2250	2250	18 ) SS.
2251	2251	19 COUNTY OF ...)
2252	2252	20 I, a Notary Public, in and for the County of ......, in the
2253	2253	21 State of ......, certify that ...., personally known to me to
2254	2254	22 be the same person whose name is subscribed to the foregoing
2255	2255	23 certificate of acknowledgment, appeared before me in person
2256	2256	24 and acknowledged that (she) (he) signed such certificate as
2257	2257
2258	2258
2259	2259
2260	2260
2261	2261
2262	2262	HB3101 - 63 - LRB103 29344 KTG 55731 b
2263	2263
2264	2264
2265	2265	HB3101- 64 -LRB103 29344 KTG 55731 b HB3101 - 64 - LRB103 29344 KTG 55731 b
2266	2266	HB3101 - 64 - LRB103 29344 KTG 55731 b
2267	2267	1 (her) (his) free and voluntary act and that the statements
2268	2268	2 made in the certificate are true.
2269	2269	3 Dated (insert date).
2270	2270	4 Signature ...................... Notary Public
2271	2271	5 (official seal)
2272	2272	6 There shall be attached a certificate of magistracy, or
2273	2273	7 other comparable proof of office of the notary public
2274	2274	8 satisfactory to the court, to a consent signed and
2275	2275	9 acknowledged in another state.
2276	2276	10 L. A surrender or consent executed and acknowledged
2277	2277	11 outside of this State, either in accordance with the law of
2278	2278	12 this State or in accordance with the law of the place where
2279	2279	13 executed, is valid.
2280	2280	14 M. Where a consent or a surrender is signed in a foreign
2281	2281	15 country, the execution of such consent shall be acknowledged
2282	2282	16 or affirmed in a manner conformable to the law and procedure of
2283	2283	17 such country.
2284	2284	18 N. If the person signing a consent or surrender is in the
2285	2285	19 military service of the United States, the execution of such
2286	2286	20 consent or surrender may be acknowledged before a commissioned
2287	2287	21 officer and the signature of such officer on such certificate
2288	2288	22 shall be verified or acknowledged before a notary public or by
2289	2289	23 such other procedure as is then in effect for such division or
2290	2290	24 branch of the armed forces.
2291	2291	25 O. (1) The parent or parents of a child in whose interests
2292	2292
2293	2293
2294	2294
2295	2295
2296	2296
2297	2297	HB3101 - 64 - LRB103 29344 KTG 55731 b
2298	2298
2299	2299	Signature ...................... Notary Public
2300	2300
2301	2301	(official seal)
2302	2302
2303	2303
2304	2304	HB3101- 65 -LRB103 29344 KTG 55731 b HB3101 - 65 - LRB103 29344 KTG 55731 b
2305	2305	HB3101 - 65 - LRB103 29344 KTG 55731 b
2306	2306	1 a petition under Section 2-13 of the Juvenile Court Act of 1987
2307	2307	2 is pending may, with the approval of the designated
2308	2308	3 representative of the Department of Children and Family
2309	2309	4 Services ("Department" or "DCFS"), execute a consent to
2310	2310	5 adoption by a specified person or persons:
2311	2311	6 (a) in whose physical custody the child has resided
2312	2312	7 for at least 6 months; or
2313	2313	8 (b) in whose physical custody at least one sibling of
2314	2314	9 the child who is the subject of this consent has resided
2315	2315	10 for at least 6 months, and the child who is the subject of
2316	2316	11 this consent is currently residing in this foster home; or
2317	2317	12 (c) in whose physical custody a child under one year
2318	2318	13 of age has resided for at least 3 months.
2319	2319	14 The court may waive the time frames in subdivisions (a),
2320	2320	15 (b), and (c) for good cause shown if the court finds it to be
2321	2321	16 in the child's best interests.
2322	2322	17 A consent under this subsection O shall be acknowledged by
2323	2323	18 a parent pursuant to subsection H and subsection K of this
2324	2324	19 Section.
2325	2325	20 (2) The final and irrevocable consent to adoption by a
2326	2326	21 specified person or persons in a Department of Children and
2327	2327	22 Family Services (DCFS) case shall be substantially as follows:
2328	2328	23 FINAL AND IRREVOCABLE CONSENT TO ADOPTION BY
2329	2329	24 A SPECIFIED PERSON OR PERSONS: DCFS CASE
2330	2330
2331	2331
2332	2332
2333	2333
2334	2334
2335	2335	HB3101 - 65 - LRB103 29344 KTG 55731 b
2336	2336
2337	2337
2338	2338	HB3101- 66 -LRB103 29344 KTG 55731 b HB3101 - 66 - LRB103 29344 KTG 55731 b
2339	2339	HB3101 - 66 - LRB103 29344 KTG 55731 b
2340	2340	1 I, ......................................, the
2341	2341	2 .................. mother or father (circle one) of a male or
2342	2342	3 female (circle one) child, state:
2343	2343	4 1. My child ............................ (name of
2344	2344	5 child) was born on ..... (insert date) at
2345	2345	6 .................... Hospital in the City/Town of
2346	2346	7 ........., in ................ County, State of
2347	2347	8 ...............
2348	2348	9 2. I reside at ......................, County of
2349	2349	10 ............. and State of ..............
2350	2350	11 Mail may also be sent to me at this address
2351	2351	12 ............................, in care of
2352	2352	13 .................
2353	2353	14 My home telephone number is......................
2354	2354	15 My cell telephone number is......................
2355	2355	16 My e-mail address is.................................
2356	2356	17 3. I, ..........................., am .... years old.
2357	2357	18 4. I enter my appearance in this action for my child to
2358	2358	19 be adopted by the person or persons specified herein by me
2359	2359	20 and waive service of summons on me in this action only.
2360	2360	21 5. I hereby acknowledge that I have been provided a
2361	2361	22 copy of the Birth Parent Rights and Responsibilities in
2362	2362	23 Illinois for Final and Irrevocable Consents to Adoption by
2363	2363	24 a Specified Person or Persons for DCFS Cases before
2364	2364	25 signing this Consent and that I have had time to read this
2365	2365	26 form or have it read to me and that I understand the rights
2366	2366
2367	2367
2368	2368
2369	2369
2370	2370
2371	2371	HB3101 - 66 - LRB103 29344 KTG 55731 b
2372	2372
2373	2373
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2375	2375	HB3101 - 67 - LRB103 29344 KTG 55731 b
2376	2376	1 and responsibilities described in this form. I understand
2377	2377	2 that if I do not receive any of my rights as described in
2378	2378	3 the form, it shall not constitute a basis to revoke this
2379	2379	4 Final and Irrevocable Consent to Adoption by a Specified
2380	2380	5 Person or Persons.
2381	2381	6 6. I do hereby consent and agree to the adoption of
2382	2382	7 such child by .......... (names of current foster
2383	2383	8 parent(s) or caregiver(s), hereinafter referred to as the
2384	2384	9 "specified person or persons") only.
2385	2385	10 7. I wish to sign this consent and I understand that by
2386	2386	11 signing this consent I irrevocably and permanently give up
2387	2387	12 all my parental rights I have to my child.
2388	2388	13 8. I understand that this consent allows my child to
2389	2389	14 be adopted by the specified person or persons only and
2390	2390	15 that I cannot under any circumstances after signing this
2391	2391	16 document change my mind and revoke or cancel this consent.
2392	2392	17 9. I understand that this consent will be void if:
2393	2393	18 (a) the Department places my child with someone
2394	2394	19 other than the specified person or persons; or
2395	2395	20 (b) a court denies the adoption petition for the
2396	2396	21 specified person or persons to adopt my child; or
2397	2397	22 (c) the DCFS Guardianship Administrator refuses to
2398	2398	23 consent to my child's adoption by the specified person
2399	2399	24 or persons on the basis that the adoption is not in my
2400	2400	25 child's best interests.
2401	2401	26 I understand that if this consent is void I have
2402	2402
2403	2403
2404	2404
2405	2405
2406	2406
2407	2407	HB3101 - 67 - LRB103 29344 KTG 55731 b
2408	2408
2409	2409
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2411	2411	HB3101 - 68 - LRB103 29344 KTG 55731 b
2412	2412	1 parental rights to my child, subject to any applicable
2413	2413	2 court orders including those entered under Article II of
2414	2414	3 the Juvenile Court Act of 1987, unless and until I sign a
2415	2415	4 new consent or surrender or my parental rights are
2416	2416	5 involuntarily terminated. I understand that if this
2417	2417	6 consent is void, my child may be adopted by someone other
2418	2418	7 than the specified person or persons only if I sign a new
2419	2419	8 consent or surrender, or my parental rights are
2420	2420	9 involuntarily terminated. I understand that if this
2421	2421	10 consent is void, the Department will notify me within 30
2422	2422	11 days using the addresses and telephone numbers I provided
2423	2423	12 in paragraph 2 of this form. I understand that if I receive
2424	2424	13 such a notice, it is very important that I contact the
2425	2425	14 Department immediately, and preferably within 30 days, to
2426	2426	15 have input into the plan for my child's future.
2427	2427	16 10. I understand that if a petition for adoption of my
2428	2428	17 child is filed by someone other than the specified person
2429	2429	18 or persons, the Department will notify me within 14 days
2430	2430	19 after the Department becomes aware of the petition. The
2431	2431	20 fact that someone other than the specified person or
2432	2432	21 persons files a petition to adopt my child does not make
2433	2433	22 this consent void.
2434	2434	23 11. If a person other than the specified person or
2435	2435	24 persons files a petition to adopt my child or if the
2436	2436	25 consent is void under paragraph 9, the Department will
2437	2437	26 send written notice to me using the mailing address and
2438	2438
2439	2439
2440	2440
2441	2441
2442	2442
2443	2443	HB3101 - 68 - LRB103 29344 KTG 55731 b
2444	2444
2445	2445
2446	2446	HB3101- 69 -LRB103 29344 KTG 55731 b HB3101 - 69 - LRB103 29344 KTG 55731 b
2447	2447	HB3101 - 69 - LRB103 29344 KTG 55731 b
2448	2448	1 email address provided by me in paragraph 2 of this form.
2449	2449	2 The Department will also contact me using the telephone
2450	2450	3 numbers I provided in paragraph 2 of this form. It is very
2451	2451	4 important that I let the Department know if any of my
2452	2452	5 contact information changes. If I do not let the
2453	2453	6 Department know if any of my contact information changes,
2454	2454	7 I understand that I may not receive notification from the
2455	2455	8 Department if this consent is void or if someone other
2456	2456	9 than the specified person or persons files a petition to
2457	2457	10 adopt my child. If any of my contact information changes,
2458	2458	11 I should immediately notify:
2459	2459	12 Caseworker's name and telephone number:
2460	2460	13 ............................................................;
2461	2461	14 Agency name, address, zip code, and telephone number:
2462	2462	15 ............................................................;
2463	2463	16 Supervisor's name and telephone number:
2464	2464	17 ............................................................;
2465	2465	18 DCFS Advocacy Office for Children and Families:
2466	2466	19 800-232-3798.
2467	2467	20 12. I expressly acknowledge that paragraph 9 (and
2468	2468	21 paragraphs 8a and 8b, if applicable) do not impair the
2469	2469	22 validity and finality of this consent under any
2470	2470	23 circumstances.
2471	2471	24 13. I have read and understand the above and I am
2472	2472	25 signing it as my free and voluntary act.
2473	2473	26 Dated (insert date).
2474	2474
2475	2475
2476	2476
2477	2477
2478	2478
2479	2479	HB3101 - 69 - LRB103 29344 KTG 55731 b
2480	2480
2481	2481
2482	2482	HB3101- 70 -LRB103 29344 KTG 55731 b HB3101 - 70 - LRB103 29344 KTG 55731 b
2483	2483	HB3101 - 70 - LRB103 29344 KTG 55731 b
2484	2484	1 .............................................
2485	2485	2 Signature of parent
2486	2486	3 (3) If the parent consents to an adoption by 2 specified
2487	2487	4 persons, then the form shall contain 2 additional paragraphs
2488	2488	5 in substantially the following form:
2489	2489	6 8a. I understand that I cannot change my mind or
2490	2490	7 revoke this consent or recover custody of my child on the
2491	2491	8 basis that the specified persons divorce or are granted a
2492	2492	9 dissolution of a civil union or that one of the specified
2493	2493	10 persons has died.
2494	2494	11 8b. I understand that if the specified persons get a
2495	2495	12 divorce or are granted a dissolution of a civil union
2496	2496	13 before the petition to adopt my child is granted, this
2497	2497	14 consent remains valid only for ............... (name only
2498	2498	15 one specified person) to adopt my child.
2499	2499	16 8c. I understand that if either of the specified
2500	2500	17 persons dies before the petition to adopt my child is
2501	2501	18 granted, this consent remains valid for the surviving
2502	2502	19 person to adopt my child.
2503	2503	20 (4) The form of the certificate of acknowledgement for a
2504	2504	21 Final and Irrevocable Consent for Adoption by a Specified
2505	2505	22 Person or Persons: DCFS Case shall be substantially as
2506	2506	23 follows:
2507	2507	24 STATE OF ..............)
2508	2508
2509	2509
2510	2510
2511	2511
2512	2512
2513	2513	HB3101 - 70 - LRB103 29344 KTG 55731 b
2514	2514
2515	2515
2516	2516	HB3101- 71 -LRB103 29344 KTG 55731 b HB3101 - 71 - LRB103 29344 KTG 55731 b
2517	2517	HB3101 - 71 - LRB103 29344 KTG 55731 b
2518	2518	1 ) SS.
2519	2519	2 COUNTY OF .............)
2520	2520	3 I, .................... (Name of Judge or other person),
2521	2521	4 ..................... (official title, name, and address),
2522	2522	5 certify that ............., personally known to me to be the
2523	2523	6 same person whose name is subscribed to the foregoing Final
2524	2524	7 and Irrevocable Consent for Adoption by a Specified Person or
2525	2525	8 Persons: DCFS Case, appeared before me this day in person and
2526	2526	9 acknowledged that (she)(he) signed and delivered the consent
2527	2527	10 as (her)(his) free and voluntary act, for the specified
2528	2528	11 purpose.
2529	2529	12 I have fully explained that by signing this consent this
2530	2530	13 parent is irrevocably and permanently relinquishing all
2531	2531	14 parental rights to the child so that the child may be adopted
2532	2532	15 by a specified person or persons, and this parent has stated
2533	2533	16 that such is (her)(his) intention and desire. I have fully
2534	2534	17 explained that this consent is void only if:
2535	2535	18 (a) the placement is disrupted and the child is moved
2536	2536	19 to a different placement; or
2537	2537	20 (b) a court denies the petition for adoption; or
2538	2538	21 (c) the Department of Children and Family Services
2539	2539	22 Guardianship Administrator refuses to consent to the
2540	2540	23 child's adoption by a specified person or persons on the
2541	2541	24 basis that the adoption is not in the child's best
2542	2542	25 interests.
2543	2543
2544	2544
2545	2545
2546	2546
2547	2547
2548	2548	HB3101 - 71 - LRB103 29344 KTG 55731 b
2549	2549
2550	2550
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2552	2552	HB3101 - 72 - LRB103 29344 KTG 55731 b
2553	2553	1 Dated (insert date).
2554	2554	2 ...............................
2555	2555	3 Signature
2556	2556	4 (5) If a consent to adoption by a specified person or
2557	2557	5 persons is executed in this form, the following provisions
2558	2558	6 shall apply. The consent shall be valid only for the specified
2559	2559	7 person or persons to adopt the child. The consent shall be void
2560	2560	8 if:
2561	2561	9 (a) the placement disrupts and the child is moved to
2562	2562	10 another placement; or
2563	2563	11 (b) a court denies the petition for adoption; or
2564	2564	12 (c) the Department of Children and Family Services
2565	2565	13 Guardianship Administrator refuses to consent to the
2566	2566	14 child's adoption by the specified person or persons on the
2567	2567	15 basis that the adoption is not in the child's best
2568	2568	16 interests.
2569	2569	17 If the consent is void under this Section, the parent
2570	2570	18 shall not need to take further action to revoke the consent. No
2571	2571	19 proceeding for termination of parental rights shall be brought
2572	2572	20 unless the parent who executed the consent to adoption by a
2573	2573	21 specified person or persons has been notified of the
2574	2574	22 proceedings pursuant to Section 7 of this Act or subsection
2575	2575	23 (4) of Section 2-13 of the Juvenile Court Act of 1987.
2576	2576	24 (6) The Department of Children and Family Services is
2577	2577	25 authorized to promulgate rules necessary to implement this
2578	2578
2579	2579
2580	2580
2581	2581
2582	2582
2583	2583	HB3101 - 72 - LRB103 29344 KTG 55731 b
2584	2584
2585	2585
2586	2586	HB3101- 73 -LRB103 29344 KTG 55731 b HB3101 - 73 - LRB103 29344 KTG 55731 b
2587	2587	HB3101 - 73 - LRB103 29344 KTG 55731 b
2588	2588	1 subsection O.
2589	2589	2 (7) (Blank).
2590	2590	3 (8) The Department of Children and Family Services shall
2591	2591	4 promulgate a rule and procedures regarding Consents to
2592	2592	5 Adoption by a Specified Person or Persons in DCFS cases. The
2593	2593	6 rule and procedures shall provide for the development of the
2594	2594	7 Birth Parent Rights and Responsibilities Form for DCFS Cases.
2595	2595	8 (9) A consent to adoption by specified persons on this
2596	2596	9 consent form shall have no effect on a court's determination
2597	2597	10 of custody or visitation under the Illinois Marriage and
2598	2598	11 Dissolution of Marriage Act or the Illinois Religious Freedom
2599	2599	12 Protection and Civil Union Act if the marriage or civil union
2600	2600	13 of the specified persons is dissolved after the adoption is
2601	2601	14 final.
2602	2602	15 P. If the person signing a consent is incarcerated or
2603	2603	16 detained in a correctional facility, prison, jail, detention
2604	2604	17 center, or other comparable institution, either in this State
2605	2605	18 or any other jurisdiction, the execution of such consent may
2606	2606	19 be acknowledged before social service personnel of such
2607	2607	20 institution, or before a person designated by a court of
2608	2608	21 competent jurisdiction.
2609	2609	22 Q. A consent may be acknowledged telephonically, via
2610	2610	23 audiovisual connection, or other electronic means, provided
2611	2611	24 that a court of competent jurisdiction has entered an order
2612	2612	25 approving the execution of the consent in such manner and has
2613	2613	26 designated an individual to be physically present with the
2614	2614
2615	2615
2616	2616
2617	2617
2618	2618
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2620	2620
2621	2621
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2623	2623	HB3101 - 74 - LRB103 29344 KTG 55731 b
2624	2624	1 parent executing such consent in order to verify the identity
2625	2625	2 of the parent.
2626	2626	3 R. An agency whose representative is acknowledging a
2627	2627	4 consent pursuant to this Section shall be a public child
2628	2628	5 welfare agency, or a child welfare agency, or a child placing
2629	2629	6 agency that is authorized or licensed in the State or
2630	2630	7 jurisdiction in which the consent is signed.
2631	2631	8 S. The form of waiver by a putative or legal father of a
2632	2632	9 born or unborn child shall be substantially as follows:
2633	2633	10 FINAL AND IRREVOCABLE
2634	2634	11 WAIVER OF PARENTAL RIGHTS OF PUTATIVE OR LEGAL FATHER
2635	2635	12 I, ...................., state under oath or affirm as
2636	2636	13 follows:
2637	2637	14 1. That the biological mother ............... has
2638	2638	15 named me as a possible biological or legal father of her
2639	2639	16 minor child who was born, or is expected to be born on
2640	2640	17 ..........., ......, in the City/Town of........., State
2641	2641	18 of ...........
2642	2642	19 2. That I understand that the biological mother
2643	2643	20 ............. intends to or has placed the child for
2644	2644	21 adoption.
2645	2645	22 3. That I reside at ................, in the City/Town
2646	2646	23 of..........., State of ................
2647	2647	24 4. That I am ................ years of age and my date
2648	2648
2649	2649
2650	2650
2651	2651
2652	2652
2653	2653	HB3101 - 74 - LRB103 29344 KTG 55731 b
2654	2654
2655	2655
2656	2656	HB3101- 75 -LRB103 29344 KTG 55731 b HB3101 - 75 - LRB103 29344 KTG 55731 b
2657	2657	HB3101 - 75 - LRB103 29344 KTG 55731 b
2658	2658	1 of birth is ..............., .............
2659	2659	2 5. That I (select one):
2660	2660	3 ..... am married to the biological mother.
2661	2661	4 ..... am not married to the biological mother and
2662	2662	5 have not been married to the biological mother within
2663	2663	6 300 days before the child's birth or expected date of
2664	2664	7 child's birth.
2665	2665	8 ..... am not currently married to the biological
2666	2666	9 mother, but was married to the biological mother,
2667	2667	10 within 300 days before the child's birth or expected
2668	2668	11 date of child's birth.
2669	2669	12 6. That I (select one):
2670	2670	13 ..... neither admit nor deny that I am the
2671	2671	14 biological father of the child.
2672	2672	15 ..... deny that I am the biological father of the
2673	2673	16 child.
2674	2674	17 7. That I hereby agree to the termination of my
2675	2675	18 parental rights, if any, without further notice to me of
2676	2676	19 any proceeding for the adoption of the minor child, even
2677	2677	20 if I have taken any action to establish parental rights or
2678	2678	21 take any such action in the future including registering
2679	2679	22 with any putative father registry.
2680	2680	23 8. That I understand that by signing this Waiver I do
2681	2681	24 irrevocably and permanently give up all custody and other
2682	2682	25 parental rights I may have to such child.
2683	2683	26 9. That I understand that this Waiver is FINAL AND
2684	2684
2685	2685
2686	2686
2687	2687
2688	2688
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2690	2690
2691	2691
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2693	2693	HB3101 - 76 - LRB103 29344 KTG 55731 b
2694	2694	1 IRREVOCABLE and that I am permanently barred from
2695	2695	2 contesting any proceeding for the adoption of the child
2696	2696	3 after I sign this Waiver.
2697	2697	4 10. That I waive any further service of summons or
2698	2698	5 other pleadings in any proceeding to terminate parental
2699	2699	6 rights, if any to this child, or any proceeding for
2700	2700	7 adoption of this child.
2701	2701	8 11. That I understand that if a final judgment or
2702	2702	9 order of adoption for this child is not entered, then any
2703	2703	10 parental rights or responsibilities that I may have remain
2704	2704	11 intact.
2705	2705	12 12. That I have read and understand the above and that
2706	2706	13 I am signing it as my free and voluntary act.
2707	2707	14 Dated: ..................., ..............
2708	2708	15 ...........................................
2709	2709	16 Signature
2710	2710	17 OATH
2711	2711	18 I have been duly sworn and I state under oath that I have read
2712	2712	19 and understood this Final and Irrevocable Waiver of Parental
2713	2713	20 Rights of Putative or Legal Father. The facts contained in it
2714	2714	21 are true and correct to the best of my knowledge. I have signed
2715	2715	22 this document as my free and voluntary act in order to
2716	2716	23 facilitate the adoption of the child.
2717	2717
2718	2718
2719	2719
2720	2720
2721	2721
2722	2722	HB3101 - 76 - LRB103 29344 KTG 55731 b
2723	2723
2724	2724
2725	2725	HB3101- 77 -LRB103 29344 KTG 55731 b HB3101 - 77 - LRB103 29344 KTG 55731 b
2726	2726	HB3101 - 77 - LRB103 29344 KTG 55731 b
2727	2727	1 ..............................
2728	2728	2 Signature
2729	2729	3 Signed and Sworn before me on
2730	2730	4 this ............ day
2731	2731	5 of ..........., 20....
2732	2732	6 ...................
2733	2733	7 Notary Public
2734	2734	8 (Source: P.A. 99-833, eff. 1-1-17; 100-1060, eff. 1-1-19.)
2735	2735	HB3101- 78 -LRB103 29344 KTG 55731 b 1 INDEX 2 Statutes amended in order of appearance HB3101- 78 -LRB103 29344 KTG 55731 b HB3101 - 78 - LRB103 29344 KTG 55731 b 1 INDEX 2 Statutes amended in order of appearance
2736	2736	HB3101- 78 -LRB103 29344 KTG 55731 b HB3101 - 78 - LRB103 29344 KTG 55731 b
2737	2737	HB3101 - 78 - LRB103 29344 KTG 55731 b
2738	2738	1 INDEX
2739	2739	2 Statutes amended in order of appearance
2740	2740
2741	2741
2742	2742
2743	2743
2744	2744
2745	2745	HB3101 - 77 - LRB103 29344 KTG 55731 b
2746	2746
2747	2747
2748	2748
2749	2749	HB3101- 78 -LRB103 29344 KTG 55731 b HB3101 - 78 - LRB103 29344 KTG 55731 b
2750	2750	HB3101 - 78 - LRB103 29344 KTG 55731 b
2751	2751	1 INDEX
2752	2752	2 Statutes amended in order of appearance
2753	2753
2754	2754
2755	2755
2756	2756
2757	2757
2758	2758	HB3101 - 78 - LRB103 29344 KTG 55731 b