Consent Petition – Illinois Parentage Act 1984 STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE 22nd JUDICIAL CIRCUIT McHENRY COUNTY ________________________________________________ vs. ________________________________________________ Case Number___________________________________ PETITION TO ESTABLISH PARENT AND CHILD RELATIONSHIP BY CONSENT OF THE PARTIES Now comes the Petitioner _____________________________________________________ pursuant to Illinois Compiled Statutes, 750 ILCS 45/1 et. seq. and moves this Court to establish the Parent and Child Relationship by consent of the parties and in support thereof states as follows: 1. Name of the Mother_______________________________________________________________ Address__________________________________________________________________________ Place of Birth_____________________________________________________________________ Date of Birth______________________________________________________________________ 2. Name of Father___________________________________________________________________ Address__________________________________________________________________________ Place of Birth_____________________________________________________________________ Date of Birth______________________________________________________________________ 3. Name of Child____________________________________________________________________ Place of Birth_____________________________________________________________________ Date of Birth______________________________________________________________________ 3a. Check this box if a public agency is providing assistance to the child. Name of Agency________________________________________________________________ Address_______________________________________________________________________ 4. That the parents of said child are not now, nor have they at any time been married to one another, but it is in the best interest of the minor child that _________________________________________ be determined to be the father of the child and that a parent/child relationship be established. CHECK THIS BOX IF YOU WANT THE COURT TO MAKE A CHILD CUSTODY DETERMINATION That the Petitioner further moves the Court to determine that it has jurisdiction pursuant to section 2104 of the Illinois Uniform Child Custody Jurisdiction Act and to award temporary custody to ______________ ______________________________________ or establish visitation rights with regard to the minor child in accordance with the standards set forth in Part V & VI of the I.M.D.M.A. and in support thereof states: CV-PET5 (Revised 12/01/06) Page 1 of 3 American LegalNet, Inc. www.FormsWorkflow.com COMPLETE THE SECTIONS THAT ARE NECESSARY TO ESTABLISH JURISDICTION FOR CHILD CUSTODY That this State a. is the home state of the child at the time of the commencement of this proceeding, and/or b. had been the child’s home state within 6 months before commencement of this proceeding and the child is absent from this state because of his/her removal or retention by a person claiming his/her custody or for other reasons, and a parent or person acting as parent continues to live in this state: That it is in the best interest of the child that a court of this state assume jurisdiction because the child and his parents, or the child and at least one contestant, have a significant connection with this state, and there is available in this state substantial evidence concerning the child’s present or future care, protection, training, and personal relationships: That the child is physically present in this state and a. the child has been abandoned b. it is necessary in an emergency to protect the child because he/she has been subjected to or threatened with mistreatment or abuse or is otherwise neglected or dependent c. it appears that no other state would have jurisdiction under the prerequisites substantially in accordance with the above noted paragraphs or another state has declined to exercise jurisdiction on the grounds that this state is the more appropriate forum to determine the custody of the child and it is in the best interest of the child that this Court assume jurisdiction. 5. That it is in the best interest of the minor child that temporary and permanent care, custody, control and education be awarded to _________________________________________________________ who is a fit and proper person. 6. That _____________________________________________ lacks sufficient property and sufficient income to provide for the reasonable needs of the minor child of the parties, including educational needs. That _______________________________________is gainfully employed earning a substantial income and is well able to provide for the child’s support in accordance with the reasonable needs of the child. 7. That _____________________________________________is without sufficient financial resources to pay ____________________attorney’s fees and costs and that ____________________________ has sufficient financial resources to pay the attorney’s fees and costs. WHEREFORE, ______________________________________________ prays for the following relief: A. That this Court enter an order establishing the existence of a parent/child relationship between the father __________________________ and the minor child _______________________________. B. That ___________________________________________ be awarded the temporary and permanent custody of the minor child of the parties. C. That _____________________________________________be awarded temporary and permanent child support in reasonable amounts from _____________________________________________. D. That reasonable attorney’s fees and costs be assessed against _______________________________ _______________________________________________________. CV-PET5 (Revised 12/01/06) Page 2 of 3 American LegalNet, Inc. www.FormsWorkflow.com AFFIDAVIT STATE OF ILLINOIS COUNTY OF McHENRY ) ) ____________________________________________________________, being first duly sworn upon oath deposes and states that ______________________________________ is the ______________________ in the above and that the foregoing petition is true and correct. ________________________________________________ Subscribed and Sworn to before me Date__________________________________, 20_______ ________________________________________________ Circuit Court Clerk – Notary Public CONSENT – APPEARANCE – WAIVER __________________________________________________ being first duly sworn upon oath, deposes and states that ___________________________________________ has read the petition and that the facts are true and correct and that by ______________________________________ signature below hereby consents to the entry of the proposed Order of Child/Parent Relationship, waives service of process, enters a general appearance and waives trial by jury on the issue of parentage. I further understand that I am entitled to court appointed counsel and that I waive such court appointed counsel. ________________________________________________ Subscribed and Sworn to before me Date__________________________________, 20_______ ________________________________________________ Circuit Court Clerk – Notary Public Name_______________________________________________ Attorney Number _____________________________________ Attorney for__________________________________________ Address______________________________________________ City, State Zip_________________________________________ Phone________________________________________________ CV-PET5 (Revised 12/01/06) Page 3 of 3 American LegalNet, Inc. www.FormsWorkflow.com