Affidavit Of Mother To Support Notice To Putative Father
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Affidavit Of Mother To Support Notice To Putative Father Form. This is a Illinois form and can be use in Dekalb Local County.
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Tags: Affidavit Of Mother To Support Notice To Putative Father, Illinois Local County, Dekalb
IN THE CIRCUIT COURT OF THE SIXTEENTH JUDICIAL CIRCUIT
DEKALB COUNTY, ILLINOIS
IN THE MATTER OF:
_____________________________________,
)
) Case No.:___________________________
)
)
AFFIDAVIT OF MOTHER TO SUPPORT NOTICE TO PUTATIVE FATHER
NOTICE TO:______________________________________
Putative Father
I, ______________________________________________________, am the mother of a child
born on __________________________, 19_____, or to be born on or about
__________________________, 19_____, state as follows:
1. That to the best of my knowledge__________________________________________________
is the father of said child whose last known address is
___________________________________________
_____________________________________________________________________________________.
2. It is my intention to place or I have placed my child with
________________________________
______________________________________________________________________________________
for the purpose of adoption.
______________________________________
Signature
______________________________________
Print or Type Name
Signed and sworn to before me this __________ day of
____________________, 19_____.
____________________________________________
Notary Public
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C:\FORMS\FA000002.FAM
REV: 8/8/98
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