CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT 251 WHEATON, ILLINOIS 60187-0707 File Stamp Here3217-2 (Rev. 06/08)DENIAL OF PATERNITY W/ENTRY OF APPEARANCE - PATERNITYPutative FatherDENIAL OF PATERNITY WITH ENTRY OF APPEARANCE CONSENT TO ADOPTIONCASE NUMBERIN THE MATTER OF NOTICE TO I, on oath state: 1. That I am years of age; that I reside at in the County of State of . 2. I hereby enter my appearance in the above mentioned cause and waive service of summons and other pleadings. 3. That I have been advised that is the mother of a male female child named born or expected to be born on or about and that such mother has stated that I am the father of this child. 4. I deny that I am the father of this child.OATH I have been duly sworn and I say 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.UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF DU PAGE IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT Signed and sworn to before meSignature DateCircuit Clerk or Notary Public 5. I further understand that the mother of this child wishes to consent to the adoption of the child. I hereby consent to the adoption of this child, and waive any rights, remedies and defenses that I may now or in the future have as a result of the mother's allegation of the paternity of this child. This consent is being given in order facilitate the adoption of the child and so that the court may terminate what rights I may have to the child as a result of being named the father by the mother. This consent is not in any manner an admission of paternity. American LegalNet, Inc. www.FormsWorkFlow.com