Free CCCO 0111 6-22-01 - Illinois

Request for Certified Copies of Court Records in Adoption Proceedings IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

(1/23/06) CCCO 0014

REQUEST FOR CERTIFIED COPIES OF COURT RECORDS IN ADOPTION PROCEEDINGS
Date of Request: ____________________________ Case File No. ______________________________

Requestor's Name: ______________________________________ Relationship to Adoptee _____________________ Street Address: City/State/Zip: Home Telephone:

__________________________________________________________ __________________________________________________________ ________________________ Work Telephone: ___________________
REQUIRED INFORMATION

__________________________________________________________________________________________ __________________________________________________________________________________________
ADOPTIVE PARENTS NAMES: a) Father: ____________________________________ b) Mother: ________________________________________ ADOPTEE: a) Full Adoptive Name: ________________________________________________ b) Date of Birth: _________________________________ Place of Birth: __________________________________
Month/Day/Year City/State

INFORMATION REQUESTED a) Decree of Adoption b) Certificate of Adoption (c) General Information

REASON FOR REQUEST (REQUIRED)

__________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________
TO PROCESS YOUR REQUEST, WE MUST RECEIVE THE FOLLOWING: A copy of a valid Driver's License, State ID or Passport; if address above is different, please explain:

______________________________________________________________________________.
A Certified or Notarized copy of your Signature. If Petitioner's last name is different due to marriage, or change of name, must provide a copy of marriage license or certified copy of Court Order changing your name. If requesting a copy of "Decree of Adoption", please enclose a money order or check in the amount of $9.00. If requesting a copy of "Certificate of Adoption", please enclose a money order or check in the amount of $9.00. Check or Money Order payable to: "Clerk of the Circuit Court of Cook County". DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS