"IN THE MATTER OF NOTICE TO ..... , PUTATIVE FATHER.
You have been identified as the father of a child born or expected to be born on or about (insert date).
The mother of the child is.....
The mother has indicated that she intends to place the child for adoption.
As the alleged father of the child, you have certain legal rights with respect to the child, including the right to notice of the filing of proceedings instituted for the adoption of the child. If you wish to retain your rights with respect to the child, you must file with the Clerk of this Circuit Court of.... County, Illinois, whose address is...., Illinois, within 30 days after the date of receipt of this notice, the declaration of paternity enclosed herewith stating that you are, in fact, the father of the child and that you intend to retain your legal rights with respect to the child, or request to be notified of any further proceedings with respect to custody or adoption of the child.
If you do not file such a declaration of paternity, or a request for notice, then whatever legal rights you have with respect to the child, including the right to notice of any future proceedings for the adoption of the child, may be terminated without any further notice to you. When your legal rights with respect to the child are so terminated, you will not be entitled to notice of any proceeding instituted for the adoption of the child.
If you are not the father of the child, you may file with the Clerk of this Court the disclaimer of paternity enclosed herewith which will be noted in the Clerk's file and you will receive no further notice with respect to the child."
The declaration of paternity shall be substantially as follows:
"IN THE CIRCUIT COURT OF THE | ||
.......... JUDICIAL CIRCUIT, ILLINOIS | ||
.......... County | ||
) | ||
) | ||
) | No. | ) |
) |
DECLARATION OF PATERNITY WITH ENTRY OF APPEARANCE
I, ........., state as follows:
OATH
I have been duly sworn and I say under oath that I have read and understand this Declaration of Paternity With Entry of Appearance. The facts that it contains are true and correct to the best of my knowledge, and I understand that by signing this document I admit my paternity. I have signed this document as my free and voluntary act.
...........
(signature)
Dated (insert date).
Signed and sworn before me on (insert date).
................
(notary public)".
The disclaimer of paternity shall be substantially as follows:
"IN THE CIRCUIT COURT OF THE | ||
.......... JUDICIAL CIRCUIT, ILLINOIS | ||
.......... County | ||
) | ||
) | ||
) | No. | ) |
) |
DENIAL OF PATERNITY WITH ENTRY OF APPEARANCE AND CONSENT TO ADOPTION
I,.......... , state as follows:
OATH
I have been duly sworn and I say under oath that I have read and understood this Denial of Paternity With Entry of Appearance and Consent to Adoption. The facts it contains are true and correct to the best of my knowledge, and I understand that by signing this document I have not admitted paternity. I have signed this document as my free and voluntary act in order to facilitate the adoption of the child.
...........
(signature)
Dated (insert date).
Signed and sworn before me on (insert date).
.................
(notary public)".
The names of adoptive parents shall not be included in the notice.
750 ILCS 50/12a