#91139

IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

COUNTY DEPARTMENT - COUNTY DIVISION

In the Matter of the Petition of:

(NAME OF PETITIONER)
and
(NAME OF CO-PETITIONER, if nec.)
(Husband and Wife if married; Petitioner if No:
Single; Petitioners if same sex couple)
TO ADOPT

(NAME OF EACH CHILD),

A Minor or Minors

PETITION FOR ADOPTION

Now come the Petitioner(s), (name of Petitioner) and (Name of Co-Petitioner, if

nec), by and through their/his/her attorney(s) (name of attorney) of (Firm) and as and for
their/his/her Petition for Adoption pursuant to 750 ILCS 50/5 they/he/she allege as follows:

1. Identify Petitioner(s) and establish his/her/their residency in IL.

Married
The Petitioners are husband and wife, of lawful age and under no legal disability. They
reside in the City of , County of Cook, and the State of Illinois. The male
Petitioner, and the female Petitioner, have each resided in
the State of Illinois for a period of 6 months immediately preceding the filing of this
Petition.

Married filing without spouse

The Petitioner is married, of lawful age and under no legal disability. He/She resides in
the City of , County of Cook, and the State of Illinois. The Petitioner has
resided in the State of Illinois for a period of 6 months immediately preceding the filing of
this Petition. The Petitioner is married but has lived separate and apart from his/her
spouse for a period exceeding 12 months. The Petitioner’s spouse is not a party to this
action.

Single
The Petitioner is unmarried, of lawful age, and under no legal disability. He/She resides
in the City of , County of Cook, and the State of Illinois. The Petitioner has
resided in the State of Illinois for a period of 6 months immediately preceding the filing of
this Petition.

Unmarried couple – same sex only (unmarried couples of opposite sex cannot
adopt)
The Petitioners are of lawful age and under no legal disability. They reside in the City of
, County of Cook, and the State of Illinois. The Petitioners have each resided in the State
of Illinois for a period of 6 months immediately preceding the filing of this Petition.

Separate Paragraphs 2-6 for each child.

2. Identify child, establish child’s residency for jurisdiction and length or

residence with the Petitioner, establish relationship of Petitioner(s) to child.

They/he/she desire(s) to adopt, (name of child),a female/male minor child who is about
(child’s age) years of age and who was born (birth date) in the City of (City), County of
(county), State of (State or Province), Country of (country - only if not U.S.). The child is
in the custody of and resides with the Petitioner(s). The child has been in the exclusive
care of the Petitioner since (date) when (brief explanation of how Petitioner came into
possession of the child). They/he/she is/are related to the child as: (choose one for each
Petitioner) parent, grandparent, brother, sister, step-parent, step-grandparent, step-
brother, step-sister, uncle, aunt, great-uncle, great-aunt, or cousin of first-degree. (If none
of the aforementioned, then state “They/he/she is/are not related to the child”).

3. Identify mother even if she is a party to the adoption.

The name of the biological mother of the child is (name) and she is a female petitioner in
this cause.

-or-

The name of the biological mother of the child is (name) and her address is (address).
The said biological mother is of lawful age and under no legal disability.

-or-

The name of the biological mother of the child is (name) and she is deceased.

4. Termination of Mother’s rights (if mom deceased – skip Par. 4)

IF Mother is a Petitioner
The mother of the child consents to the adoption of the minor by the Petitioners herein,
and her consent is evidenced in writing by her signature on this Petition for Adoption.

IF Mother is not a Petitioner

On information and belief, the mother of the child will consent to the adoption of the child
by the Petitioner(s) herein.

-or- (and also could be “in the alternative”)

The biological mother of the child (grounds go here – here are the 2 most often used
grounds. There are 13 total) abandoned and deserted her said child for a period in
excess of three months immediately preceding the filing of this Petition, and she has
failed to maintain a reasonable degree of interest, concern or responsibility as to the
welfare of her children. The said mother is therefore an unfit person and her consent to
this adoption is not necessary.

5. Identify father even if he is a party to the adoption

IF there is a Legal Father (i.e. father on child’s b.c. born after 1996 –or- married to
mother at time of child’s birth or conception –or- not married to mother but a
parentage Order has been entered finding father to be legal father.

The name of the legal and biological father of the child is (name) and he is a male
petitioner in this cause.

-or-

The name of the legal and biological father of the child is (name) and his address is
(address). The said father is of lawful age and under no legal disability.

-or-

The name of the legal and biological father of the child is (name) and he is deceased.

IF No Legal Father

The name of the biological father of the child is believed to be (name) and his address is
(address). The said biological father is of lawful age and under no legal disability. The
legal father of the child is unknown.

-or-

The name of the biological father of the child is believed to be (name) and he is
deceased. The legal father of the child is unknown.

-or-

The legal and biological father of the child is unknown.

6. Termination of Father’s rights (if “legal” father deceased – skip Par. 6)

The father of the child consents to the adoption of the minor by the Petitioner(s) herein,
and his consent is evidenced in writing by his signature on this Petition for Adoption.

-or-

On information and belief, the father of the child will consent to the adoption of the child
by the Petitioner(s) herein.

-or- (and also could be in the alternative)

The biological father of the child (grounds go here – here are the 2 standard most often
used of the 13) abandoned and deserted his said child for a period in excess of three
months immediately preceding the filing of this Petition, and he has failed to maintain a
reasonable degree of interest, concern or responsibility as to the welfare of his children.
The said father is therefore an unfit person and his consent to this adoption is not
necessary.

7. Identify any prior Orders that have been entered involving custodial or
parental rights toward the minor child

No orders have been entered heretofore in any Court affecting the custody, adoption or
parental rights of the Petitioner(s) to these minors, except the orders entered in this
proceeding, and (Any other paternity, divorce, custody, juvenile court etc. Order which
involved the child to be adopted must go here) except the Order previously entered by the
(identify Court) in (identify case: parties, case number) awarding (identify relief awarded
affecting the custodial right to the child.

8. Standard language saying the Petitioner(s) are capable and competent to

adopt

The Petitioners are reputable persons of good moral character with sufficient ability and
financial means to rear, nurture and educate the said children in a suitable and proper
manner.
 Your Petitioner(s) make (name of each child), a minor, (name of mother of each
child if not a party to action), the biological mother of (name of child), and (name of father
of each child if not a party to action), the biological father of (name of child), and (if no
legal father) the UNKNOWN FATHER AND TO ALL WHOM IT MAY CONCERN, parties
defendant to this cause, and

ASK THE COURT:

A. To appoint a Guardian ad Litem to represent the interests of the minor

child(ren) sought to be adopted in this proceeding;

B. To appoint some suitable agency or person to investigate this matter as

required by law and to report the results of the investigation in writing to this Court;

C. For leave to adopt as their own child the said minor(s) and for leave to change
the name of said minor(s) from (current legal name) to (requested legal name); and
(additional request for each child).

D. For such further relief and for the entry of such additional order or orders as
may be necessary or appropriate in the proceeding.

(name of Petitioner),Petitioner (name of other if nec.), Petitioner

 C E R TI FI CATI O N

Under penalties as provided by law pursuant to Section 1-109 of the Code of Civil
Procedure, the undersigned certify that the statements set forth in this instrument are true
and correct, except as to matters therein stated to be on information and belief and as to
such matters the undersigned certify as aforesaid that they truly believe the same to be
true.

Dated:

(name of Petitioner),Petitioner (name of other if nec.), Petitioner

/s/

Attorney for: Petitioners

Address
Chicago, IL 60602
Phone #
Attorney No: #