STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT _____________ COUNTY _____________________, Plaintiff and _____________________, Defendant ) ) ) ) ) ) No. ____-- __ --____ ) PETITION FOR CHILD SUPPORT I, ________________________________, without the assistance of an attorney, ask this Court to order Defendant to pay child support to me. In support of my Petition, I state the following items are true to the best of my knowledge: 1. This Court has jurisdiction over the subject matter and the parties. 2. I am ____ years old; my address is: ____________________________________; I live in ____________ County; and I have lived in Illinois for at least 90 days before I filed this Petition. 3. The other parent's name is _______________________, he/she is _____ years old; his/her address is:___________________________________; and he/she is __ is not __ a resident of Illinois. 4. That Defendant and I are the biological parents of the following child(ren): ___________________________________________________________________________ ___________________________________________________________________________ , all of whom live with me. 5. That Defendant is not contributing financially to the support of these child(ren). American LegalNet, Inc. www.USCourtForms.com 6. That Defendant has the financial ability to pay child support to Plaintiff. WHEREFORE, I request: that the Court order A. Defendant to pay ___ % of his/her monthly income as and for support of the minor child/ren. B. Defendant to pay a percentage of his/her monthly income as and for any past due support of the minor children. C. Defendant to be required to maintain health insurance for the minor children if provided by his employer. ______________________, ___________ Under penalties as provided by law pursuant to Section 5/1-109 of the Code of Civil Procedure, the undersigned certifies 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 certifies as aforesaid that she/he verily believes the same to be true. ________________________, ___________ _________________, pro se _________________ _________________ American LegalNet, Inc. www.USCourtForms.com