IN THE CIRCUIT COURT OF THE TWENTY-THIRD JUDICIAL CIRCUIT DEKALB COUNTY, ILLINOIS _______________________________________________ _______________________________________________ Petitioner(s), vs. _______________________________________________ _______________________________________________ Respondent(s). ) ) ) ) ) ) ) ) ) ) CASE NO. ___________________________________ AFFIDAVIT FOR PUBLICATION Petition for Adoption of a Child named _______________________________________ ___________________________________________________________________________________, being first duly sworn, says he/she is (a) _________________________________________________________________________________ and further states: 1. That the Respondent (b) ________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ 2. That the Respondent reside(s) (c) ________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ __________________________________________________________ __________________________________________________________ Subscribed and sworn to before me this ________ day of __________________________, 20________________. ______________________________________________ Notary Public Insert name of "Petitioner" or "Attorney for Petitioner" Insert correct facts as set forth in Chap. 110, Par. 14, I.R.S. Insert address of non-resident Respondent when known. (a) (b) (c) Affidavit for Publication Rev. 04-01-16 American LegalNet, Inc. www.FormsWorkFlow.com