IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT LAKE COUNTY, ILLINOIS ) ) ) ) ) ) ) ) ) Petitioner and Case No. __________________________ Respondent CHILD REPRESENTATION ORDER Pursuant to 750 ILCS 5/506, the court appoints the attorney named below to serve as: Child(ren)'s Representative. Attorney to represent the child(ren). Guardian ad litem (GAL). The Parties shall contact the attorney and provide him/her with relevant pleadings within two (2) days. 1. Attorney Name: _______________________________________________________ Telephone _____________________ Address: ______________________________________________________________________________________ 2. Children Name ________________________________________ ________________________________________ ________________________________________ ________________________________________ Age _______ _______ _______ _______ Residing with ______________________________________ ______________________________________ ______________________________________ ______________________________________ 3. Fees Fees, costs, and the initial retainer shall be paid as follows: Party A ________ % Party B ________ % Other ________ % The initial retainer is set at $_______________ to be paid within ______________ days. The attorney appointed herein shall file with the court a detailed invoice for services rendered within 90 days and shall send a copy to each party. The case is set for the review of initial fees on ___________________________________ (Insert a date not later than 90 days from date of this order.) 4. Parties Party A: Name of Party ____________________________________________________ Telephone _______________ Address ___________________________________________________________________________________ Attorney __________________________________________________________ Attorney's address _________________________________________________ Party B: Name of Party ____________________________________________________ Telephone _______________ FAX ____________________ Telephone _______________ Address ___________________________________________________________________________________ Attorney __________________________________________________________ Attorney's address _________________________________________________ Page 1 of 2 Telephone _______________ FAX ____________________ 171-344 (Rev. 06/13) American LegalNet, Inc. www.FormsWorkFlow.com 5. Scope If appointed as an Attorney to represent the child(ren), the attorney shall represent the child(ren) in a normal attorneyclient relationship. If appointed as a Child's Representative, the attorney shall advocate as an attorney for the child(ren)'s best interests and shall disclose the position as to what he/she intends to advocate in a pretrial memorandum that shall be served upon all concerned parties of record prior to the trial. If appointed as a GAL, the attorney shall submit a report addressing the following issues: ______________________________________________________________________________________________ ______________________________________________________________________________________________ 6. Rule 4.2 Consent Pursuant to Rule 4.2 of the Rules of Professional Conduct, the attorneys for the parties hereby consent to direct communication between their clients and the attorney appointed to serve as an attorney for the child(ren) or as a Child's Representative. An attorney for a party may elect at any time to revoke a written 4.2 consent by written notice to the attorneys of record. __________________________________________ Attorney for Petitioner ________________________________________________ Attorney for Respondent 7. Releases If one or more of the children herein is over the age of 12 and is or has been the recipient of mental health or developmental disabilities services, the attorney appointed herein is given leave to file a motion requesting an order authorizing him or her to inspect and copy any record kept by the therapist or agency in the course of providing such services pursuant to 740 ILCS 110/4(a)(5). Issue of release is reserved. If one of more of the children herein is under the age of 12 and is or has been the recipient of mental health or developmental disabilities services, the attorney appointed herein is given leave to file a motion requesting an order directing one of the parents to sign releases authorizing him or her to inspect and copy any record kept by the therapist or agency in the course of providing such services pursuant to 740 ILCS 110/4(a)(1). Issue of release is reserved. 8. Other _________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ Dated at Waukegan, Illinois this day of , 20 Enter: JUDGE Prepared by: Name: _____________________________________________ Attorney's Name: ____________________________________ Address: __________________________________________ City: ______________________________ State: __________ Phone: ______________________Zip Code: _____________ Fax: ______________________________________________ ARDC #: __________________________________________ Page 2 of 2 171-344 (Rev. 06/13) American LegalNet, Inc. www.FormsWorkFlow.com