IN THE CIRCUIT COURT OF THE TWENTY-THIRD JUDICIAL CIRCUIT DEKALB COUNTY, ILLINOIS IN THE MATTER OF BABY (BOY / GIRL) _____________________________________ ) ) ) ) ) CASE NO. ____________________________ SUPPLEMENTARY INTERIM ORDER In accordance with Interim Order entered herein on ____________________________________ and impounded, IT IS HEREBY ORDERED that _________________________________________ (institution) deliver custody of the above-entitled child to _______________________________________________, Child Welfare Worker of DeKalb County, Illinois, for temporary custody placement by her/him in accordance with above Interim Order. IT IS FURTHER ORDERED that the Clerk of the Circuit Court be authorized to make a certified copy of this Supplemental Interim Order only. DATED: ______________________________ _____________________________________________ Judge Supplementary Interim Order Rev. 04-01-16 American LegalNet, Inc. www.FormsWorkFlow.com