Dorothy Brown, Clerk of the Circuit Court of Cook County, Illinoiscookcountyclerkofcourt.orgPage 1 of 1en-US2734 Denial of Paternity with Entry of Appearance and Consent to Adopt þ (//19) CCCO 0026 en-USIN THE CIRCUIT COURT OF COOK COUNTY, ILLINOISen-USIN THE MATTER OF NOTICE TO: Putative Father: þ Address: þ þ City, State, Zip: þ þ I, þ en-US state as follows: 1. That I am þ years of age; that I reside at þ en-US þ , in the County of þ en-US State of þ en-US. 2. That I have been advised that þ en-US is the mother of a þ þ male þ female child born on þ , or expected to be born on or about þ en-US, anden-USthat such mother has stated that I am the father of this child. 3. en-USI Deny that I am the father of this child. en-USI further understand that the mother of this child wishes to consent to the adoption of the child. I herebyen-USconsent to the adoption of this child and waive any rights, remedies and defenses that I may now or in theen-USfuture have as a result of the mother222s allegation of paternity of this child. This consent is being given in orderen-USto facilitate the adoption of the child and so that the court may terminate any rights I may have to the child as aen-USresult of being named the father by the mother. This consent is not in any manner an admission of paternity. 5. en-USI hereby enter my appearance in the above entitled cause and waive service of summons and other pleadings. Signature: þ en-USOATH Case No. þ en-US Printed Name Signature: Dated: I have been duly sworn and state under oath that I have read and understand 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.