COUNTY DIVISION

STANDING ORDER
CALENDAR 1
Gloria Contreras
Adoption Case Coordinator
Room 1701
(312) 603- 2492
Fax: (312) 603-4351
TDD (312) 603-6673
CJCAL3@cookcountygov .corn
Effective for all cases filed on and after May 22, 2006, the following procedures will be
in effect for all cases assigned to Calendar 1 in the County Division of the Circuit Court of Cook
County. Amended Effective February 10, 2009.
I. Call Times
8:45A.M. Routine Motions
9:30A.M. Initial presentment of Adoption related matters, Petitions for Interim
Orders, Case Management Conferences, Calendar Status Dates, and
Regular Motions in all Adoption related cases, except Petitions for the
Appointment of a Confidential Intermediary (750 ILCS 50/18.3a); all other
matters pertaining to Adoption related cases, except contested hearings or
trials.
11:00 A.M. Set Matters
1:30 P.M. Initial presentment of Adoption related matters, Petitions for Interim
Orders, Case Management Conferences, Calendar Status Dates and
Regular Motions in all Adoption related cases, except Petitions for the
Appointment of a Confidential Intermediary (750 ILCS 50/18.3a), all other
matters pertaining to Adoption related cases, except contested hearings or
trials.
2:00P.M. Set Matters
II. Routine Motions
The following motions are considered routine and may be resolved without a court
appearance:
To File Amended Petition (with proposed pleading attached; Counsel should consider
the impact of Supreme Court Rule 105 when filing such motions);
Order of Default (Notice is required to all Parties not in Default; e.g. Guardian ad
Litem). All such Motions must be accompanied by a Military Affidavit;
Issuance of Passport, Permission to Travel Out ofthe State oflllinois and Authorize
Medical Care (prior to entry of final judgment);
Motion to Allow Examination of Court File by Petitioner's Attorney;
Certified Copy of Judgment of Adoption;
Motion to Amend Judgment (correct typographical error);
Appointment of Special Process Server;
Permission to proceed as a Special Needs Adoption,
Permission to Sue or Defend as an Indigent Person (Must use Forms CCG689 and
CCG 689 B);
Motion to Delete Identifying Information; and
Continuing Date Set for Entry of Judgment.
Courtesy copies of all Routine Motions and the proposed Order should be delivered to the
Presiding Judge's Chambers, Room 1701, no later than 4:00p.m. on the court date prior to the
scheduled date. There is no requirement that such Motions be pre-screened by the appointed
Guardian ad litem. Notice must be served on the Guardian ad Litem if the Motion seeks relief
affecting any named or unnamed party, changing a court date set by prior order or the status of the
adoptee as established by the Interim Order entered in the matter. If no objection is raised, the Order
will be entered on the 9:30a.m. Call. Orders will be available for pick up after 12:00 p.m. in Room
1701. Objections to Routine Motions can be made by telephone to the Presiding Judge's Office
(312.603.2492) in the afternoon of the business day prior to the date scheduled or by 9:00a.m. on
that date. If an objection is received, no order will be entered, movant's counsel will be notified and
required to reschedule the matter on the 9:30 a.m. or 1:30 p.m. Motion Call.
Routine Motions not requiring notice to any other person or party can be dropped off at the
Presiding Judge's Chambers any day during regular business hours. Every effort will be made to
enter the appropriate order by 12:00 p.m. for orders received in the morning and 9:00a.m. on the
succeeding court day for motions delivered after 12:00 p.m.
To facilitate the Court's business, every Routine Motion should be accompanied by a Notice
of Motion, regardless of whether notice is required, stating that the matter is to be heard on the
Routine Motion Call and containing the date that counsel wishes to have the order entered. As a
courtesy, copies of all orders entered on the Routine Motion call will be placed in the appropriate
GAL's mail slot.
III. 9:30A.M. and 1:30 P.M. Calls
A. Matters Heard
The Court will entertain Regular Motions, Case Management Conferences, Calendar Status
Calls and Initial Presentments of all Adoption Related Matters, Petitions for an Interim Order (750
ILCS 50/13 ), execution of consents, Petitions for Adjudication of Dependency and Appointment of
Guardian with Authority to Consent to an Adoption (705 ILCS 405/2-4 and 2-29),appointment of
counsel and appointment of a Guardian ad Litem for minor birth parent(s). Contested matters
requiring extensive argument or an evidentiary hearing will be scheduled for the Set Call at either of
these calls. Contested Adoption cases may be scheduled for pre-trial on motions presented on either
the 9:30 a.m. or 1:30 p.m. Adoption Call.
Contested matters will be normally not be heard on the 9:30A.M. Call, but rather scheduled for
hearing on the Set Call for Calendar 1. In most instances, the matter will be heard by the judge
assigned to Calendar 1 who scheduled the matter for a contested hearing. Courtesy copies of all
contested motions and supporting memoranda, together with the opponent's response and movant's
reply shall be delivered to the Presiding Judge's Chambers by movant's counsel no later than seven
days prior to the date scheduled for the hearing of the contested motion. Counsel should consider this
requirement in scheduling contested hearings. No dates for argument will be continued on
motions which the parties have been given an opportunity to brief. In the event a party is not
prepared to argue on the date set by the Court, the motion(s) will be decided on the briefs.
The parties, with the concurrence of a Judge assigned to the County Division, may request a
pre-trial assignment to a Judge for the purpose of settlement discussions other than the one presiding
over Calendar 1. Only one such request will be honored. The fact that a pre-trial conference was
conducted by any Judge to whom the matter is transferred for trial shall not, in and of itself, serve as
grounds for a substitution of Judge for cause and constitutes a waiver of all parties' right to a
substitution of Judge pursuant to 735 ILCS 5/2 B 1001(a)(2).
B. Courtesy Copies
Courtesy copies of all Petitions for Adoptions without exhibits or attachments and motions
which are intended to be filed or presented on the 9:30a.m. or 1:30 p.m. shall be delivered to the
Chambers of the Presiding Judge no later than 3:00p.m. on the court date prior to the intended date
of presentment. Failure to comply with this directive may result in a delay or postponement of the
initial hearing on the Petition and/or request for an Interim Order (750 ILCS 50/13) relating to the
child's custody and care during the adoption proceeding. This delivery requirement may be satisfied
by e-mail to CJCAL3@cookcountygov.com or telephone facsimile delivery. The Court encourages
and prefers the use of e-mail to satisfy this delivery requirement. The Adoption Case Coordinator
will use her best efforts to acknowledge receipt ofthe courtesy copy.
All Adoption related cases shall remain on Calendar 1 until Judgment is entered, or if
contested, until the Presiding Judge or his designee has closed discovery, resolved all dispositive
motions and certified the case as ready for trial. At such time, the matter shall be randomly
assigned to one of the several Judges in the County Division assigned to Calendar 1 for trial. This
will be accomplished randomly by selecting by lot one of the Calendars over which one ofthe
eligible Judges preside and then transferring the case from Calendar 1 to the selected Calendar.
. Judges will use their best efforts to schedule the commencement of an assigned trial within 30
days of the trial assignment date.
IV. Set Matters
These consist of contested pre-trial matters on Calendar 1 and trials that have been randomly
assigned to Calendar 3 (Presiding Judge's Calendar) for trial. Procedures for pre-trial filings such as
trial briefs or motions in limine will be discussed and ordered by the designated trial calendar at the
time the matter is set for trial. Contested hearings in cases pending on Calendar 1, where the parties
have agreed to a briefing schedule can be scheduled electronically. Trials cannot be scheduled or
continued via an electronic communication with the Court.
V. Administrative Matters
A. Appointment and Duties of Guardians ad Litem
The Court shall appoint a Guardian ad Litem ('GAL') as follows:
Case Number ending in '0 or 1'
Case Number ending in '2 or 3'
Case Number ending in '4 or 5'
Case Number ending in '6 or 7'
Case Number ending in '8 or 9'
Ellen E. Douglass
Genie Miller Gillespie
Nancy Hablutzel
Diana E. Lopez
Gerald F. Murray
The appointment will be made at the time of initial presentment or the entry of any Interim
Order providing for the care, custody or control ofthe person sought to be adopted .. It shall be the
duty of counsel for the Petitioner to furnish the appointed GAL with a copy of the Petition for
Adoption, Interim Order and any other material normally provided to the GALs in similar cases. In
adoptions where the GAL is appointed as investigator, counsel shall deliver a completed affidavit
from each Petitioner concerning their background substantially in the form found at Exhibit 2
together with any exhibits required. Counsel is also responsible for obtaining any criminal
background information and providing information necessary to complete any C.A.N.T.S. search
required by this Standing Order.
As a convenience, the Presiding Judge's Office will accept such documents for delivery to the
GAL's mail slot. Counsel should be aware that the documents will be picked up by the GAL as their
schedule permits. The Presiding Judge's Office will not undertake the responsibility of delivering
such materials to the GAL's personal office.
The Court will also determine if an investigation is necessary pursuant to 7 50 ILCS 50/6 and
enter the appropriate order at the time of initial presentment.
In all cases, the Guardian shall file an appearance as Guardian ad Litem for the adoptee
within 14 days of appointment. From the date of appointment, the GAL shall receive notice of all
requests for relief made to the Court by any party as required by either the Rules of the Illinois
Supreme Court or the Circuit Court of Cook County. The GAL may file any response deemed
necessary to advance the best interest of the adoptee.
The appointed GAL will be available for consultation with counsel by telephone or e-
mail, in person by appointment or by any other mutually agreeable medium. Contact information
for the GALs is attached as Exhibit 3.
If the GAL chooses, an answer may be filed on behalf of the adoptee. This pleading
must comply with 735 ILCS 5/2-610. No default will be entered against a child for the failure to
file an answer absent an order compelling the filing of such pleading.
The GAL shall, in addition to the above, do the following:
Review Court file in each case to make certain that pleadings are proper, service is
effected on all necessary parties, and that all parental rights have been finally and
properly terminated
1
;
In all cases where the Petitioner(s) are related to the child-adoptee as defined by
750 ILCS 5011 B, and where investigative report has been prepared by a licensed
agency or the Department Adoption and Child Advocacy, the GAL shall have the
discretion to meet with the child-adoptee in an appropriate setting to determine the
child's position concerning the proposed adoption. In such cases where one of the
Petitioners is the step-parent of the child, the GAL shall obtain and review all
documents necessary to determine whether the child is available for adoption and
the Petitioners' legal relationship to each other and the child(ren). The GAL is
appointed to represent the child's best interest and not the expressed preference of
the child. In those cases where an irreconcilable conflict arises in those positions,
the GAL shall act in accordance with the suggestions of the American Bar
Association standards and seek appointment of a successor GAL and remain in
the case to zealously advocate the child's position as their attorney;
Remain apprised of all situations which affect the child-adoptee's status quo as it
existed at the time of the entry of the Interim Order;
Attend and participate in all contested and /or settlement hearings or conferences
in the case. Conduct all necessary discovery in connection therewith;
In cases where the parental rights of the adoptee's biological parents have
been terminated in a Juvenile Court proceeding which remains pending,
contact the child's Guardian ad Litem in those proceedings to determine if
anything has arisen in the child's life that remains to be brought to the
attention of the Juvenile Court Judge which that person believes would be
relevant to the decision to be made by this Court. In such instances, the GAL
may desire to contact the Assistant State's Attorney and the case worker to
determine if such information is material to a determination of whether the
adoption is in the child's best interest. The accounts received should be
1
The Clerk of Court will continue to verify the fmality of any parallel Juvenile Court proceedings (see Section
V. K. below).
analyzed by the GAL to determine whether such information should be
brought to the attention of the Court. If so, the GAL should file the appropriate
motion for leave to obtain any and all supporting material which the GAL
deems relevant to the child's best interest. In exercising discretion in this area,
the GAL should consider that this Court is not sitting in review of decisions
made by the Judges of the Child Protection Division of this Court. Petitioners'
attorneys can facilitate this process by furnishing the GAL with the case
workers contact information and the identity of the Public Guardian as soon as
possible after appointment.
Review the investigative reports prepared in connection with the adoption and
investigate any issues that arise in the report which adversely impact what the
GAL believes is in the adoptee's best interest. Absent the known existence of
contrary facts or an inherent inconsistency in the investigative report, the GAL is
presumed to be acting in a reasonable manner by relying on the facts set out in the
investigative report without undertaking any independent investigation;
In all adoptions where no investigative report is prepared for Court review by a
licensed agency or the Department of Adoption and Child Advocacy, formerly
the Department of Supportive Services, obtain and review a Criminal History
from the Illinois State Police as a result of a fingerprint search, a CANTS
(Required Form in Appendix)and Sex Offender Registry search on any Petitioner
who is not related to the child as a biological or legal parent. A person holding a
license issued by the State of Illinois or the Judiciary of this State or employed by
any private or public entity which requires as a condition of licensure or continued
employment a criminal background check may satisfy this requirement by filing
with the Court a statement from such employer, on official letter head, that a
criminal background check was conducted in the past two years and no
disqualifying offenses were disclosed. Counsel may obtain waivers of the criminal
history check for good cause in other individual cases by a properly noticed
Motion seeking such relief.
In order to facilitate compliance with the requirements of this Standing Order
concerning background checks, the Court has established a program with the
Department of Adoption and Child Advocacy ("Department"). The individual
being fingerprinted must establish his or her identity with a valid photo
identification. An Illinois driver's license or state identification card is usually
acceptable. To obtain a fingerprint record, contact the Department (312) 603-
0550, to schedule an appointment and determine the current fee schedule and
acceptable forms of payment. Their offices are located at 69 W. Washington St.,
Suite 818 in the George W. Dunne Administration Building. The fee is currently
$50. For this fee, the Agency will monitor the compliance with this requirement.
This service consists of directing the individual to the Sheriffs office, obtaining a
result ofthe fingerprint search and forwarding information to the office ofthe
Presiding Judge. The Sheriffs Fingerprint Unit is located on the 7th floor ofthe
Richard J. Daley Center. The hours are Monday through Friday from 8:30a.m. to
10:30 a.m. After the fingerprinting is completed, the original print card will be
delivered to the applicant for mailing to the Illinois State Police. The search will
take approximately 4 weeks. The results will be forwarded directly to The State of
Illinois has authorized private vendors to facilitate criminal background checks.
A listing of the vendors in Cook County is listed in the Appendix to this Standing
Order.
If no investigative report by a licensed agency or the Department has been
required by the Court and it comes to the attention of the GAL that a petitioner
who is not the biological parent of the adoptee has committed
2
any offense
involving sexual abuse of any person, physical abuse or abandonment of a child,
or been convicted of any felony offense as defined by the laws of the jurisdiction
in which it occurred, the GAL shall petition the Court to order an investigative
report prior to the entry of a judgment of adoption. Nothing herein shall preclude
the GAL from requesting the Court to order a new or additional investigative
report in any case where the GAL believes that such information will be relevant
and necessary to the Court's resolution of the matter;
In all cases, in lieu of an answer, file with the Court a recommendation, in a form
substantially similar to Exhibit 1, as to what is in the best interest of the child
based upon a review of all available data. If the GAL concludes that the adoption
is in the best interest of the child, a consent to the adoption should be filed by the
GAL in all cases where the child is under the age of 14.
The GAL will no longer 'screen' motions, proposed judgments or other pleadings
before presentment to the Court. If the GAL wishes to support or oppose any
relief sought by the movant, a proper pleading must be filed which advances the
GAL's position. Copies of such pleadings must be served on all parties as
required by the applicable rules.
Notwithstanding the foregoing, in cases where the Petitioner(s) are seeking to adopt a minor
who is their biological child and their parental rights were terminated in another proceeding and
that child has become available for adoption because their legal parent(s) have died, become
disabled or otherwise are unable to parent, the Court will appoint the Office of the Cook County
Public Guardian to serve as Guardian ad Litem for the minor child.
B. Fees for Guardians ad Litem
For all cases filed on and after July 1, 2006 the following fee schedule shall be in effect.
In special needs adoptions or re-adoptions subsequent to a special needs adoption, the GAL's fee
shall be $125.00 in a single child adoption. In such cases where more than one child is sought to
be adopted, the GAL shall receive $50.00 for each additional child. The total fee in special needs
adoption shall not exceed $225.00, unless the GAL has received authority from the Court to incur
additional fees. Such approval must be obtained by proper motion and notice.
2
Committed includes any offense for which there has been an adjudication of guilt regardless of whether a
judgment of conviction was entered; e.g. a disposition of supervision.
For all cases filed on and after March 1, 2009 in all related, non-related agency or private
placement adoption cases, the GAL shall receive $175.00 for acting as GAL and an additional
$50.00 if additionally charged with serving as the investigator in the matter. Provided
nevertheless, that if the Petitioner( s) have completed the adoption of the child under the laws of a
country other than the United States or this adoption proceeding is commenced with the
concurrence of a Guardian for the child appointed by such foreign State, including cases in which
one or both of the Petitioners have been appointed to that office, the fee shall remain $125.00. If
the GAL determines to conduct an interview with the child-adoptee, other than to obtain the
consent of a minor adoptee of the age of 14 years and older, he or she shall will be paid at the
hourly rate established by Supreme Court Rule for appointed counsel plus travel expense at the
rate of $0.50.5 per mile plus parking and tolls. Such additional fees will be awarded only after a
hearing conducted after presentment of a proper petition.
The Court does not currently .appoint GALs in adult adoption cases. In the event that a
judge determines such appointment is appropriate the fee will be $200.00.
All other fees, as established by General Order ofthe County Division (04 CoMS 23)
entered October 29, 2004 are superseded by this order.
The scheduled fees are due and payable as of the date of appointment.
C. Investigatory Reports
All investigative reports prepared by licensed child welfare agencies and the Cook
County Department of Adoption and Child Advocacy shall comply with the format for such
reports as established by Administrative Order of the Illinois Department of Children and Family
Services and be dated not later than four months prior to the date of the filing of the Petition for
Adoption. The format is found at the forms section of the Department's website.
(www.state.il.us.dcfs). (Form CPS 411).
D. Interim Orders and Orders on Initial Presentment
In order to comply with the requirements of750 ILCS 50/13, such orders will be entered
in the following situations:
In cases where all parental rights have been surrendered. otherwise terminated, or
their identity is unknown because the child was found abandoned, the Court will
enter an Interim Order placing the child(ren) in the Petitioner or Petitioners' care,
custody and control pursuant to an interim custody order upon a showing, in
adoptions other than that of a related child or through an agency, that such person
or persons will provide suitable temporary custodial care for such child or
children (750 ILCS 50/13 A);
In cases where one biological parent has consented to adoption or surrendered
their parental rights and the child or children have been placed by the biological
parent or an agency with the Petitioner or Petitioners, upon a showing that the
whereabouts or identity of the other biological parent is unknown, an interim
custody order will be entered. In order to make such a showing, the Court will
require, at a minimum, an Affidavit ofldentification (Form CCCO 0032;
available on line at www.cookcountyclerkofcourt.org and/or an Affidavit
showing factually what steps have been taken to locate and notify the absent
biological parent.;
In all other cases, no order relating to custody will be entered unless the Court has
obtained jurisdiction over the absent biological parent by service of summons or
publication and such person has been served with notice of the hearing requesting
such relief in accordance with the Rules. Provided, nevertheless, that any party
may seek such relief in all cases without notice in accordance with 750 ILCS
50/13 (f).
E. Ex Parte Interim Orders
Any request for the entry of an Interim Order pursuant to 750 ILCS 50/13(f) ('Ex parte
Order') shall be made by separate Petition supported by an affidavit stating facts which
demonstrate that notice of the proceeding to any person possessing parental rights should be
excused because immediate danger and irreparable harm will occur to the child if such notice is
given. Courtesy copies of such motions together with supporting documents which are intended
to be presented shall be delivered to the Chambers of the Presiding Judge no later that 3:00p.m.
on the business date prior to the intended presentment for cases scheduled for the 9:30 a.m. call
and 10:00 a.m. on the same date for matters on the 1:30 p.m. call.
F. Setting Matter for Judgment
At the conclusion ofthe hearing on the initial presentment of the Petition for Adoption, if
appropriate, Counsel for the Petitioner(s) shall select a proposed date for entry of Judgment. This
will be scheduled by entry of a Case Management Order (Exhibit 4). Said date shall be no sooner
than seven business days after the expiration of any statutory waiting period.
Counsel for the Petitioner shall, no later than fourteen days prior to the date set for
judgment, deliver to the chambers ofthe Presiding Judge a Completed Notice of Motion Form
(CCGN003) available on line at www.cookcountyclerkofcourt.org with proper notice requesting
the entry of a Judgment of Adoption. The Motion shall be accompanied by the proposed
judgment and all supporting documents. The GAL and all other parties entitled to notice shall
receive a copy of all materials submitted to the Court. Counsel should consider this fact in
sequencing a date for entry of judgment. The matter will be heard on the date set for judgment by
the case management order.
No later than five business days before the date scheduled for entry of Judgment, the
GAL shall cause to be delivered to the chambers of the Presiding Judge either a completed
Report of the Guardian ad Litem (Exhibit 1) consenting to the entry of judgment or a pleading
stating why judgment should not be entered. Copies of either document shall be served on all
parties of record as required by the Rules. If the GAL raises issues that may be informally
resolved, the parties are directed to exercise their best efforts to reach a resolution prior to the
date set for judgment. If they are unable to do so, they may submit an "Agreed Order" to the
Court re-scheduling the date set for entry of judgment. The Petitioner may also appear and
request a hearing on the Motion for Entry of Judgment. If the matter is to be contested the matter
will not be resolved on the date set for judgment, the Petitioner's counsel should obtain three
dates from the GAL for a hearing on the Set Call. Any such continuance may be obtained
electronically ifthe Court receives an "Agreed Order" prior to 1:00 P.M. on the date set for entry
of judgment.
The Judgment will be entered on the scheduled date, unless the Petitioner and/or the GAL
have requested a delay in the entry of judgment, the Court schedules a hearing on the matters
raised by the GAL or raises, sua sponte, issues which preclude the entry of judgment. Once the
Judgment has been entered and docketed, no Motion to Modify such Judgment will be
entertained without proof that the statutory fee has been paid to the Clerk of Court.
Counsel for the Petitioner may contact the Chambers of the Presiding Judge after 3:00
p.m. on the business day prior to the hearing to determine if a court appearance is necessary to
resolve any issues precluding the entry of judgment.
In the event no order is submitted to the Court for entry on the date set for judgment, the
Court, on its own motion, will continue the matter for 21 days on the 9:30a.m. or 1:30 p.m. call
and notify counsel to appear. Failure of counsel to appear on the continued date will result in a
vacation of all existing orders and a dismissal of the matter for want of prosecution. No Motion
to Vacate such a dismissal order will be entertained absent a showing that the required fee has
been paid to the Clerk of Court.
Certified copies of judgments of adoption entered more than thirty days prior to the
request can only be obtained by filing a motion and paying the required fee. The Clerk of Court
has forms for this purpose available in Room 1202.
G. Taking of Consents to Adoption
All consents not governed by 750 ILCS 50/10 (0) (Consent to Adoption in a proceeding
under the Juvenile Court Act of 1987), shall be general in nature and be in a form substantially
similar to that as provided by statute(Form CCCO 005; available on line at
www.cookcountyclerkofcourt.org. In addition, where the consent is executed by the biological
mother, she shall also contemporaneously execute an Affidavit of Identification in a form
substantially similar to that set out in the Adoption Act. (750 ILCS 50111). This form is also
available from the Clerk's website. Such Affidavit ofldentification shall be filed with the Court
prior to the entry of Judgment and shall become a part ofthe Court record. Provided
nevertheless, upon a showing that the jurisdiction where the consent was taken allows specific
consents to adoption, the Court will accept such consents as required by 750 ILCS 50/10 (L). A
Guardian ad Litem or attorney for minor birth parents will only be appointed after the initiation
of adoption proceedings.
The Illinois Department of Corrections has developed a video conferencing system to
accommodate litigants, administrative agencies, inmates and the courts in resolving pending
matters. An inmate ofthe Illinois Department of Corrections who has agreed to execute a consent
to the adoption of their biological child should do so via a video conference.
In order to convene the conference, counsel for the moving party must obtain an order from this
Court allowing the consent via video conference. This must be done by motion presented on the
9:30 a.m. or 1:30 p.m. call for Calendar 1. Notice of the Motion must be served on the Office of
Lisa Madigan, Attorney General. At this time, notices should be directed to the attention of
Assistant Attorney General Matthew Smith, 100 W. Randolph Street, 13th Floor, Chicago,
Illinois 60601. Notice shall be delivered to the Attorney General not later than 10 business days
before the date for hearing.
The consents will be acknowledged before an employee of the Department of Adoption and
Child Advocacy designated to acknowledge consents in adoption proceedings.
Counsel is advised to coordinate the scheduling of the video conference with the Office of the
Attorney General and Department of Adoption and Child Advocacy prior to the hearing so that
an agreed order can be entered. Counsel is responsible for furnishing the inmate with the proper
forms necessary to document the consent prior to the video conference and file same with the
Clerk of Court.
H. Court Reporters and Interpreters
Official court reporters should available for the 9:30 a.m. or 1:30 p.m. calls. Consents
and surrenders of parental rights are acknowledged in the presence of an official court reporter.
Counsel is requested to advise the Adoption Case Coordinator of the necessity of a court reporter
at least one business day before the court appearance. The individual will be required to present
valid photo identification at the time of the acknowledgment. The Court enjoys the resources of
Spanish and Polish language interpreters. If counsel believes an interpreter is necessary for the
effective acknowledgment of a consent or surrender, a request for this service should be made at
least one business day prior to the date of appearance.
Other foreign language interpreters should be privately arranged. The Court will inquire
of the suggested individual to determine their credentials to act as a foreign language interpreter.
This will include an inquiry into the person's experience and impartiality. While family members
or law office employees may be acceptable for interpreting routine court matters, they will not
normally be acceptable as interpreters in contested matters or proceedings such as the
acknowledgment of consents or surrenders.
I. Calendar Status Hearings
As the vast majority of Adoption cases are concluded within six months of filing, the
Clerk of Court shall schedule a Calendar Status hearing for pending adoption related cases in
December of each year. The Call will consist of all adoption related matters, except Confidential
Intermediary proceedings, which have been filed at any before March 1 of the year in which the
Calendar Call is conducted. Notice of that date will be given to all counsel or unrepresented
parties of record no later than twenty-one days prior to the selected date. Counsel, familiar with
the file, and all prose parties shall appear at the scheduled hearing. No Calendar Status hearing
will be scheduled by the Clerk in any matter which has been disposed prior to the date
established by the Presiding Judge or which has a scheduled court date subsequent to the
Calendar Status hearing date established by the Presiding Judge.
J. Access to Court Files
At the time of initial presentment, Counsel may obtain an Order granting future access to
the Court file for the instant adoption. The Clerk will furnish the petitioners' counsel of record
with certified copies of the judgment if requested within thirty days after the matter is concluded.
After that time, certified copies will only be available by court order entered pursuant to a routine
motion.
Adoptive parents may obtain a certified copy of the judgment by an expedited petition
process. Request forms are available from the Clerk. The parent must complete the form, present
valid photo identification and pay the required fee. A judge will review the documents and enter
an order if appropriate. As some files are stored offsite, there may be a delay in obtaining the
certified copy. Requests by adoptees will be processed in the same manner. However, in most
instances, information concerning biological parents will be deleted.
Any other party to the proceedings may petition the Court for access to the court file. This
request must be made on the 9:30 a.m. or 1:30 p.m. call. Notice of the motion must be served on
all parties who have a privacy interest in maintaining the confidentiality of the court record.
Access to confidential adoption information can also be obtained under the confidential
intermediary program established by the Adoption Act (750 ILCS 50/ 18.3a)
K TerminationofParental Rights by Default
In the Court's opinion, a direct conflict exists between the provisions of the Adoption Act
(750 ILCS 50/1 et seq.) which provides Athat notwithstanding any contrary provision@ of the
Adoption Act notice of the adoption proceedings be given to any person identified as the child's
father in an affidavit filed in accordance with Section 11 of the Adoption Act (750 ILCS 50/7 C
(f)) and states that the failure to timely register with the Putative Father Registry is deemed to be
a waiver of any right to any notice in a judicial proceeding for the adoption ofthe child (750
ILCS 50/12.1 (h). Hence, the Court will not terminate the parental rights of any person named in
such affidavit and who has received no notice of the adoption proceedings solely because such
person failed to timely register with the Putative Father Registry.
Petitioners seeking to default any necessary party to an adoption proceeding based
upon service by publication must file a supporting affidavit establishing factually the action taken
that demonstrates honest and well directed efforts to ascertain the whereabouts of the
person sought to be defaulted by such service.
3
The factual showing of the inability to serve or
locate the person sought to be defaulted has also been defined as a showing of due diligence or
more succinctly a showing that would lead a reasonable person to conclude "that kind of search
or investigation which a diligent person intent on ascertaining a fact, would usually and
ordinarily make.4 An affidavit as to military service (CCG 0004) status of any named person
sought to be defaulted must also be filed in all cases where the identity of a putative father has
been made known to the Petitioner or any other party to the proceeding.
Counsel seeking an Order of Default terminating the parental rights of any person should
make certain that at the time of service, either personal, substitute or by publication that the
complaint on file is legally sufficient to support a termination of parental rights.
L. Verification of Finality of Parallel Proceedings
In Adoption cases where the parental rights of a biological or legal parent have been
terminated in a Juvenile Court proceeding, this Court is unable to enter a Judgment of Adoption
until the appeal rights of each such parent have been exhausted. This must be established by
counsel for the petitioner.
Ifthe termination proceedings were conducted in the Circuit Court of Cook County,
upon Motion the Court will direct the Clerk of Court to certify the status of any appeal from an
order terminating parental rights. Counsel is responsible for preparing an appropriate motion ,
order and verification statement. For the convenience of counsel these documents have been
standardized as forms by the Clerk of Court Forms CCCO 0010, 0011 and 0013 are available at
the Clerk's website.
If such proceedings occurred in any other circuit court ofthis State or another State,
counsel for the petitioner must file an affidavit stating with particularity the status of any such
appeal. Such affidavit may reflect the hearsay statement of an identified court official who has
advised counsel of the information. Counsel would be well advised, however, to obtain a
certified copy of the docket or mandate issued in such cases.
M. Appointment of Counsel/Experts
A biological or legal parent who appears in an Adoption proceeding is entitled to have
legal counsel ifthe Petitioner(s) seek to involuntarily terminate their parental rights. If that
person is indigent, the Court is required to appoint counsel. If an individual seeks appointment of
3
Bell Federal Savings & Loan Ass 'n. v. Horton, 59 Ill. App. 3d 923 (1978)
4 In re A.S.B. 293 Ill. App. 3d 836,842 (1997).
counsel, an Affidavit of Assets and Liabilities (CCG Form 0041 available online at
www.cookcountyclerkofcourt.org must be completed and presented to the Court for review on
the 9:30 a.m. or 1:30 p.m. adoption call. Counsel will be appointed from a list of attorneys
maintained by the Presiding Judge's Office.
Fees in such cases cannot exceed the hourly rate for appointed counsel set by Supreme
Court Rule. Requests for fees must be made by Petition either verified or supported by an
affidavit, detailing the time expended and work performed which was necessary in representing
the client's interest. To facilitate payment, the petition should also include a copy of the Affidavit
of Assets and Liabilities signed by the client and the order of appointment.
The Court will not authorize payment for the services of an expert unless the engagement
has been approved by the Court prior to any services being rendered.
N. Communication with the Court
The Court encourages parties to communicate electronically via
CJCAL3@cookcountygov.com. Please direct all communications to the Adoption Case
Coordinator, Ms. Contreras. Required courtesy copies may be submitted electronically. In
addition, scheduling of most matters, other than trials, can be accomplished without a court
appearance by the use of email. Counsel will be responsible for furnishing the Court with
appropriate orders.
0. Petition for Adjudication of Dependency of Minor with Appointment of a
Guardian with Power to Consent or Place Child for Adoption. (705 ILCS
405/2-4 & 2-29)
In cases where a party is seeking the appointment of a Guardian for a minor who was born
in or resides in Illinois, and has been placed by one or both of the child's biological parents with
one or more persons who are residents of another State in contemplation that the child will be
adopted in their home State by the person or persons with whom the child has been placed the
following procedure must be followed:
A person must file a Petition pursuant to 705 ILCS 405/2-4 alleging that the child is
dependent because at least one of its biological or legal parent( s) have or will consent to the
adoption of the child. In those cases where one of the biological or legal parents has not, for any
reason, consented to the adoption of the child, the Petition must also contain sufficient
allegations to support termination of the parental rights of the non-consenting parents.
In such cases, a consent to the adoption by the biological mother will not be
acknowledged unless it is accompanied by an Affidavit ofldentification in conformity with 750
ILCS 50/11.1. The Petition must also allege the facts surrounding the placement of the child, i.e.
how the biological parent(s) and adoptive parent(s) were placed in contact with each other. This
Petition must show that all such actions were in strict compliance with the Child Care Act of
1969 as amended (225 ILCS10/1 et seq.).
In those cases where the rights of the biological or legal parent are terminated as a result
of their consent, this court will consider appointing the Guardian designated by the Petitioner
with authority to place and/or consent to the adoption of the child in accordance with 750 ILCS
405/2-29.
In cases where the biological rights of one ofthe parents cannot be terminated upon filing
of the Petition, the Court, upon proper showing, will consider appointing the designated
individual guardian of the minor child within accordance with 705 ILCS 405/2-27 (1). The
matter shall then be continued to give the Petitioner reasonable time to terminate the parental
rights of any other biological or legal parent whose consent has not been obtained.
P. Standby Adoptions
Any person seeking the entry of an Order for Standby Adoption as defined by 750 ILCS
5011 S may join in a Petition for Adoption filed by a person seeking to adopt a minor child(ren) or
file a separate Petition seeking an Order of Standby Adoption. This Administrative Order
establishes the procedures to be followed.
1. Joint Petitions
In all cases where an adoption and standby adoption are sought in the same filing, the
party seeking an Order for Standby Adoption must be identified in the caption of the case as a
petitioner(s). A separate count, clearly identified as a Petition for an Order of Standby Adoption,
must be added to the Petition for Adoption. (735 ILCS 5/ 2-603(b) The Count must comply with
the pleading requirements set out at 750 ILCS 50/5F, and if applicable 50/5C.
In such cases, the Court will proceed to adjudicate only the counts of the petition which
seek to adopt the minor child(ren). If the Court finds grounds to grant an adoption, the
petitioner(s) shall present a Judgment Order for Adoption consistent with the prayer for relief in
those portions of the petition seeking adoption. The proposed judgment shall contain language
consistent with Illinois Supreme Court Rule 304a. The proposed judgment should also state that
the matter remains pending to resolve that portion of the matter seeking an Order for Standby
Adoption.
No consent by a legal or biological parent to a standby adoption will be ackriowledged by
the Court until a final judgment of adoption has been entered.
In the event that the Court denies the petition for adoption, the petition for an Order of
Standby Adoption will be dismissed as moot, sua sponte.
2. Stand Alone Petitions
In all cases which seek only an Order for Standby Adoption, the petitioner(s) must
comply with the pleading requirements found at 750 ILCS 50/5F, and if applicable 50/5C. All
persons who have existing parental rights to any child(ren) for whose welfare a Petition for Order
of Standby Adoption is sought, the child(ren) and any duly appointed guardian for such minor
child(ren), except a Guardian ad litem for a minor child appointed in connection with a
proceeding under the Juvenile Court Act of 1987 shall be made Respondents in the proceeding.
(705 ILCS 405/1-1 et seq.).
3. Interim Order
Upon a showing that all respondents are within the jurisdiction of the Court, petitioner(s)
may seek an Interim Order pursuant to 750 ILCS 50/13D. Consistent with practices in other
cases, the Court will appoint a Guardian ad litem from the panel designated by the County
Division and order an investigation as to the welfare of the child. Unless the Petition for an Order
for Standby Adoption asserts a claim of unfitness the matter shall be scheduled for the entry of
the final Order. In all cases, regardless of whether the respondent parent has appeared, if the basis
for the relief sought is anything other than consent, an evidentiary hearing to determine the
validity of the allegations will be conducted.
4. Order for Standby Adoption
Ifthe Court finds after hearing or upon review of the required submissions, that it is for
the welfare of the child(ren) that an Order for Standby Adoption be entered, counsel for the
petitioner shall submit a final order in the matter. The order shall, at a minimum, recite the legal
basis for the order; e.g. the biological/legal parent has executed a consent to the Order for
Standby Adoption; the finding that the Court finds that an adoption of the child(ren) will be for
their welfare; that any consent to an adoption shall not become effective until a Judgment of
Adoption is entered; that nothing in the Order for Standby Adoption affects the parental rights of
the consenting parent(s); and that the Order for Standby Adoption becomes null and void unless a
motion for entry of a judgment of adoption is filed with the Clerk of Court not later than 60 days
after the party who has obtained the Order for Standby Adoption has received knowledge of the
facts which allow for the application of a judgment of adoption.
5. Obtaining a Judgment of Adoption
The person(s) named as standby adopting parent(s) shall, within the time provided by the
statute file a verified petition seeking a judgment of adoption. The filing shall be made in the
same case in which the Order for Standby Adoption was entered. The petition shall allege facts
which demonstrate the date upon which the Petitioner(s) became aware of the circumstances
which allow the entry of a judgment of adoption and that there has been no change of
circumstances since the entry of the Order for Standby Adoption. If there has been a change of
circumstances, facts setting forth such change shall be alleged.
Any spouse of the person seeking a judgment of adoption shall join in the petition. Notice
ofthe Petition shall be served upon the child(ren) sought to be adopted; any person with whom
the child(ren) reside; any person with existing parental rights and the Guardian ad litem
previously appointed, if still serving in that position. If the Guardian ad litem is no longer a
member of the panel designated by the County Division, the petitioner shall, by motion, seek the
appointment of a successor Guardian.
Upon review of the Petition, the Court unless it appears that there is clear and convincing
evidence to suggest that the circumstances have changed so that it may no longer be in the best
interest ofthe child(ren) to finalize the adoption and the Guardian ad litem has filed a satisfactory
report, a judgment will be entered. The Court, in the exercise of its sound discretion, may order
such additional investigation as deemed appropriate. If necessary, the petitioner may seek an
interim order terminating any existing parental rights, providing for thetemporary care and
custody ofthe child and what other relief is available pursuant to 750 ILCS 50/13A.
Q. Inter-Country Adoptions
The Adoption Act requires that all placements of children born outside of the United
States or territories thereof shall comply with the rules promulgated by the "United States
Department of Immigration and Naturalization." (750 ILCS 50/4.1) In addition, on Aprill, 2008,
the Hague Convention on Inter-Country Adoptions ("Convention") became effective. This treaty
establishes substantive requirements that must be fulfilled before an adoption can be finalized in
the United States. Information concerning the application of this Convention can be found at
http:/ /adoption.State.gov.
In all such adoptions which are to be finalized in this Court on or after the date of this
Amendatory Order, where the child was born in a country which has adopted the Convention, the
Petition for Adoption must establish compliance with the Convention or allege facts which
establish that the Convention has no application to the individual case.
If the child was born in a country which is not a signatory to the Convention or the
Convention is not otherwise applicable to the proceeding the Petition for Adoption must allege
sufficient facts to establish that the placement of the child with the adoptive parents is in
compliance with the rules and regulations ofthe United States Department of Immigration and
Naturalization, or any successor Agency.
R. Forum non Conveniens
The Court reserves the right to decline sua sponte to exercise jurisdiction over adoption
proceedings in those cases where there is no reasonable connection between the parties and Cook
County. Examples of such cases are adult adoptions where none of the parties are residents of
Cook County and adoptions filed by non-residents of Cook County as a result of a non-relative
private placement of a child born outside of Cook County
. . .
JUDGE PATRIC-K MoGANN-1510
FtBIOI?.oml
Dated: February 9 , 20 9
P t
k E M G DOROT!-iY BROWN
a n.c . . c ann CLERK OF THE CIRCll!!. <i< OURT
Pres1dmg Judge OF COOK
(/
Exhibit 1
Report of GAL
(Insert Case Caption)
REPORT OF GUARDIAN Ad Litem
Comes now, _______________ ,, appointed by this Court to act as
the Guardian ad Litem for the child(ren) sought to be adopted and recommends that this Court
enter a Judgment of Adoption as being in the best interest of the child(ren). This
recommendation is made as a result of my investigation and review of these proceedings as
required by the court's Standing Order and more specifically:
1. The child(ren) is/are available for Adoption as defined by statute because:
D The Parental Rights of the biological/legal (strike one) mothers were
D terminated by this Court
D terminated by a surrender or irrevocable consent to adoption
executed by the mother
D terminated in another proceeding and all appeal rights have been
exhausted.
D The Parental Right of the biological legal (strike one) father were
D terminated by this Court
D terminated by a surrender or irrevocable consent to adoption
executed by the father
D terminated in another proceeding and all appeal rights have been
exhausted.
2. The Petitioner(s) is/are fit and proper person(s) to adopt the child(ren) and will, in my
opinion, provide a safe and proper environment for the Adoptee(s). that this opinion is based
upon the following:
D The conclusions found in an investigation conducted by a child welfare
agency approved by the Illinois Department of Children and Family
Services which I have reviewed and find complete and accurate
D The conclusions found in an investigation conducted by the Cook county
Department of Supportive Services which I have reviewed and find
complete and accurate.
D The results of my own investigation which were based in part by the
Affidavits submitted by the Petitioners detailing their background, which
proved accurate and correct. More specifically, I find that
D The Petitioners are related to the child(ren) as: ______ _
D That the child(ren) has/have resided with the Petitioners for
D That the results of a criminal history and C.A.N.T.S. check, as well
as a search of the Sex Offender Registry yielded negative results
with the exception of which I believe
does not impact on the welfare of the child(ren) because ___ _
3. The Petitioner's religious affiliation is
------------------
4. The child(ren)'s religious affiliation is ________________ _
5. D the following child(ren) is/are under the age of 14 years:
and as the
--------------------------------
duly appointed Guardian ad Litem, I hereby enter their consent to this adoption.
Respectfully submitted
Guardian ad Litem
Exhibit 2
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
COUNTY DEPARTMENT, COUNTY DIVISION
CASE NUMBER ___ COAD __ _
AFFIDAVIT
I, _____________________ , in support of my petition
to adopt do submit the following
information to the Court for investigation and review.
1. My date of birth is _____________ , age: _____ _
2. Have you ever been known by another name ? DYes D No If yes, please state those names
and the date(s) and reason for the change of name on a separate sheet of paper.
3. My present address is
. I have lived there since
---------------------------
______ . (If less than 5 years please state the addresses and dates of residence during
that time on a separate sheet of paper).
4. My home telephone number is ________ . My work number is ______ _
5. My Social Security Number is: ____________________ _
6. I am D married D separated; date of ___________ D not married.
7. The date and place of my marriage was __________________ _
8. I D have D have not been previously married. (If you have been married before, on a separate
sheet ofpaper, state the date ofthe marriage, the reason (divorce, death of a spouse) and exact
date that the marriage ended. Note, you are required to furnish the investigator with
documentary proof that any prior marriage has ended.
9a. D I am currently employed by which is
located at . My occupation is ________ _
My gross annual income is $ . I have been employed for years. (If
less than 5 years, on a separate sheet of paper, list your places of employment during that time.)
9b. D I am not currently employed. My current source(s) of income is (are) ______ _
____________________ from which I derive an annual gross
income of$
--------
9c. D I am retired after working years for _______________ _
as a(n) . My retirement income from all sources is $
-------
per year.
10. I D have not Dhave (choose one) been arrested and charged with a criminal offense other
than a traffic violation punishable by fine only. (If your answer is yes, on a separate sheet of
paper, list every incident for which you were arrested, the charge, describe your involvement, the
date of arrest and the court disposition.).
11. I D have not D have (choose one )been advised that the Department of Children and Family
Services has made an 'indicated' finding for abuse or neglect of a child residing in the same
household where I lived. (If your answer is yes, on a separate sheet of paper, please list the date
of every incident, the allegation, whether you were required to attend court and the disposition.).
12. I Dam not Dam (choose one)required to register as a sex offender.
13. The names and ages ofthe child(ren) being adopted are ____________ _
14. I Dam Dam not related biologically or by marriage to the child(ren) being adopted as their
15. I Dam Dam not related biologically or by marriage to a biological parent of the child(ren)
being adopted as their
------------------
16. The child(ren) sought to be adopted D have D have not resided in my home. If yes. How .
long? ____________ _
17. My religious belief is __________ _
18. The child(ren)'s religious beliefis
Under penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure, the
undersigned certifies that the statements set forth in this instrument are true and correct.
Preferred method of contact
Updated 3/30/2009 2:43 PM
Exhibit 3
Guardians Ad Litem Contact Information


Ellen E. Douglass Genie Miller Gillespie
53 W. Jackson 1009 53 W. Jackson Blvd. Suite 304
Chicago, Illinois 60604 Chicago, Illinois 60604
312-461-0111 312-786-9510*
312-461-9695 (telecopier) 773-259-8317 (Cell)
Eedconbrio@aol.com 312-786.9203 (Fax)
Cases ending 0 or 1 866-438-2189* (Fax)
gmg@illinoisadoptonlawyer.com *
Cases ending 2 or 3


Nancy Hablutzel Diana E. Lopez
Hablutzel and Associates Monteagudo, Lopez & Diaz, LLC
55 W. Monroe St., Suite 3700 1837 West Cermak
Chicago, Illinois 60603 Chicago, Illinois 60608
312-266-8520* 773-940-0594 (General)
312-953-4308 (Cell) 773-305-2751 (Fax)
312-266-8507 (Fax) 773-678-4491 (cell)*
NancyZH@aol.com dl@mldattorneys.com *
Cases ending 4 or 5 Cases ending 6 or 7


Gerald F. Murray
326 S. Lombard Avenue
Oak Park, Illinois 60302
708-848-6469
708-406-1600 (Fax)
gfmurray1@comcast.net
Cases ending 8 or 9


EXHIBIT4.
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
COUNTY DEPARTMENT, COUNTY DIVISION
IN RE: THE PETITION OF
TO ADOPT
)
)
)
)
)
)
COAD
CASE MANAGEMENT ORDER
This matter coming on to be heard on the initial presentation ofthe Petition of the
Petitioners and the Court:
0 having reviewed the Petition, examined the Petitioners in open Court and entered an
Interim Order relating to the care, custody and control of'the person sought to be adopted, this
matter is continued for the entry of a Judgment of Adoption on
____________ , 20 __ at 9:30 A.M./1:30 P.M.
0 the proposed judgment together with copies of all supporting documents shall be
delivered to the Chambers of the Presiding Judge of the County Division not later than
_____________ , 20 __ together with appropriate notice requesting entry
of judgment. Copies of all submitted materials shall be served on the Guardian ad Litem. A
DATE NOT LESS THAN 14 DAYS PRIOR TO SCHEDULED JUDGMENT DATE.
0 having reviewed the Petition and consulted counsel, the matter is continued to
___________ , 20 at 9:30 A.M./1:30 P.M. for: ____ _
ENTER: __________ _
JUDGE No.
Name:
J.D.
Attorney For:
Address:
City:
Phone:
EXHIBITS
CAPTION
SUBSEQUENT CASE MANAGEMENT ORDER (4519)
This matter coming on for case management conference and:
D The Parties and the Guardian ad Litem agreeing;
D The Court finding:
That the following matters remain to be resolved preventing the entry of a Judgment of
Adoption, to wit:
IT IS ORDERED:
That this matter is continued for a subsequent case management conference on
__________ , 20 __ at 9:30 a.m./ 1:30 p.m. Counsel must appear to report on
the status ofthe matter on that date. Appearance is waived ifthe proposed judgment and
supporting materials are submitted to the Court and the Guardian ad Litem not later than 14 days
prior to that date.
ENTER: _____________ _
Judge No.
Name:
I.D.
Attorney For:
Address:
City:
Phone:
APPENDIX
State Approved Lives can (Fingerprint) Vendors
Diamond Detective Agency
1651 S. Halstead St.
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2630 S. Wabash Ave.
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Trace Identity Services, Inc.
222 Vollmer Road, Ste. AC
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708-754-2900
CFS689
6/01
Illinois Department of Children and Family Services
AUTHORIZATION FOR BACKGROUND CHECK
Child Abuse and Neglect Tracking System (CANTS)
For Programs NOT Licensed by DCFS
NOTE: Oo not use this fonn if you are an ap!)llcant for licensure or an employe&!volunteer of a
licensed child care facility. Please contact your licensing representative.
Name:

Date of Birth:----- Gender (circle): Male Female
Race: ____ _

StraaVApt#
City Stale Zip Code
List all addresses at which you have resided in the past five years:
List maiden name and/or all other names by which you have been known: (last. first, middle)
I hereby authorize the Ullnols Department of Children and Family Setvlces to conduct a search of the Child Abuse and
Neglect Tracking system (CANTS) to determine whether I have been a perpetrator of an Indicated Incident of child
abuse and/or neglect or Involved In a pendlng lnvestlgatlon. I furthar consent to the release of this Information II:> the
agency listed below.
Mail this request to;
Departti'ientofCfu1dren and' Family Services
406 E. Monroe- Station# 30
Sinned Date Springfield,lL 62701
\Jpe. mol<:jleUers or latlt!l;
(Agency Nam&)
(Contact Person}
(Addre&S)
{Qilytstsle/Zip)
RETURN THIS SIGNED AND COMPLETED FORM TO THE
GUARDIAN AD LITEM IN CASE' NUMBER CoAD