Ill. R. Cir. Ct. Cook Cnty. 19A app A
STATE OF ILLINOIS COUNTY OF COOK | ) |
) | SS |
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IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, JUVENILE DIVISION | |
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IN THE INTEREST OF | ) |
) | No. |
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Minor(s) | ) |
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PETITION FOR ADJUDICATION OF WARDSHIP
___ ORIGINAL ___SUPPLEMENTAL ___ ____________________SUPPLEMENTAL Now comes __________________________________, and petitions this court to adjudicate_______________________, a ward of the court. In support, petitioner, on oath or affirmation, based on information or belief states as follows:
1. __________________________________________ is a (male/female) minor born on______, 19___, who resides or may be found in this County at ____________________________________________, Illinois ___________.
2. The names and residence addresses of the minor's parents, legal guardian, and/or custodian
Name | Residence Address | City and State |
Father: | ||
Mother: | ||
Legal: | ||
Guardian: | ||
Custodian: |
The minor and the persons named in this paragraph are designated respondents.
3. The minor was _____ not taken into protective custody. _____ taken into protective custody on _____, 19______, at ______(a.m./p.m.).
4. A Temporary Custody hearing has been set for ____, 19_____, at______(a.m./p.m.).
( )5. The minor was neglected pursuant to Juvenile Court Act, section _____ 2-3(1)(a), (lack of care), the facts supporting this are _______________________ _____ 2-3(1)(b), (injurious environment), the facts supporting this are ______________ _____ 2-3(1)(c), (drug exposed infant), the facts supporting this are ________________
( )6. The minor was abused pursuant to Juvenile Court Act, section _____ 2-3(2)(i), (physical abuse), the facts supporting this are ___________________ _____ 2-3(2)(ii), (substantial risk/physical injury), the facts supporting this are ________ _____ 2-3 (2) (iii), (sexual abuse), the facts supporting this are ____________________ _____ 2-3 (2)(iv), (torture), the facts supporting this are __________________________ _____ 2-3(2)(v), (excessive corporal punishment), the facts supporting this are _________
7. The minor is dependent pursuant Juvenile Court Act section 2-4, the facts supporting this are_____________________________________________________________
8. It is in the best interest of the minor and the public that the minor be adjudged a ward of the court.
WHEREFORE, petitioner prays that the minor be adjudged a ward of the court and that the court enter such orders as are in the best interest of the minor and other relief under the Juvenile Court Act.
__________________________________________
Petitioner
__________________________________________
Family Folder Number ___________________
Key Date of individual responsible for case
______________ MARS/CYSIS Number _____________________________
VERIFICATION
I, _________________________________, being first duly sworn on oath, depose and state that I am (an employee of the Illinois Department of Children and Family Services/ ___________________________), that I have read the foregoing Petition and am familiar with the contents and allegations contained therein and that, to the best of my knowledge and belief, the contents and allegations are true and correct.
__________________________
Subscribed and sworn to
before me __________,19____.
__________________________
Notary Public of
the Clerk of the Court
Ill. R. Cir. Ct. Cook Cnty. 19A app A