Complaint (08/05/16) CCSD N618 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, DOMESTIC RELATIONS DIVISION __________________________________________________ v. __________________________________________________ No. COMPLAINT NOW COMES Petitioner, ___________________________________________________________ , and says: 1. This action is brought pursuant to the provisions of the Illinois Parentage Act of 2015 (750 ILCS 46) or other applicable law _____________________________________________________________________. 2A. Petitioner and Respondent engaged in sexual relations from ________ to _______, in the State of Illinois, or ________ . As a direct result of such acts, Petitioner Respondent became pregnant, and gave birth to a male female child in the State of Illinois, County of Cook, or ________________________. The minor child was born on ____________, is named _________________________________________ and presently resides with ___________________________________. At the time the child was conceived, the mother was or was not married or was in the process of dissolution of marriage. At the time the child was born, the mother was or was not married or was in the process of dissolution of marriage. If married when conceived or born, the name and address of the person the mother was married to is _____________________________________________________________________________________ State/county and case number of dissolution of marriage (if any) and judgment date: _____________________________________________________________________________________ -or2B. A legal parent-child relationship has been previously established by Administrative adjudication or adoption of child or Order of Court in the Circuit Court of Cook County, docket number ____________________ or Order of Court in other jurisdiction _________________________ Voluntary Acknowledgment of Paternity or a valid gestational surrogacy contract under the Gestational Surrogacy Act or other law or an unrebutted presumption of parentage of the child under Section 204 of the I llinois Parentage Act. 3. Petitioner seeks to determine the non-existence of a parent-child relationship. 4. There is or is not any other custody/visitation/guardianship proceeding pending OR any other order affecting the Allocation of Parental Responsibilities of the child(ren) who is subject of this proceeding, entered by: (a) another division of Cook County Circuit Court; (b) an administrative body/court of this state or any other jurisdiction. 5. If so, give (a) the name and location of the court or administrative agency ___________________________; (b) the case number _________________; (c) the names of the parties______________________________. WHEREFORE, YOUR PETITIONER PRAYS FOR AN ORDER: Establishing a parent-child relationship. Establishing the non-existence of a parent-child relationship. Establishing Modifying Enforcing Terminating child support. Establishing Modifying Enforcing Allocation of Parental Responsibilities. Other ________________________________________________________________________________. Attach copies of Voluntary Acknowledgements of Paternity, orders or documents from other courts or administrative bodies, or other pages or exhibits as necessary. CERTIFICATION Under penalties as provided by law pursuant to 735 ILCS 5-1-109, 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 s/he verily believes them to be true. Dated: ____________________________ _____________________________________________________ Petitioner DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com