Dorothy Brown, Clerk of the Circuit Court of Cook County, Illinoiscookcountyclerkofcourt.orgPage 1 of 1en-US � en-USen-US Request Date: � en-US Requestor Name:� � Case File No.: � en-US Address: � � Relationship to Adoptee: � en-US City: � � State: � � Zip: � en-US Home Phone: � Work Phone: � en-US Email: � en-US en-USADOPTIVE PARENTS NAMES: a) Father: � � b) � Mother: � en-USen-USADOPTEE: Full Adoptive Name: � en-US Date of Birth: � � Place of Birth: � en-US en-USCity/State INFORMATION REQUESTED: � � Decree of Adoption � � � � General Information en-USREASON FOR REQUEST - REQUIRED en-USTO PROCESS YOUR REQUEST, WE MUST RECEIVE THE FOLLOWING: 225 en-USA copy of a valid Driver222s License, State ID or Passport; if address above is different, please explain:225 � � � � � � � 225 � � � � � � � � � � � � � � � � � � � � � � � en-USCourt Order changing your name. 225 en-USIf requesting a copy of 223Decree of Adoption224, please enclose a money order or check in the amount of $9.00. 225 � � � � � � � � � � � � � � � � � � 225 en-USCheck or Money Order payable to: 223Clerk of the Circuit Court of Cook County224.en-US