of 0required · order (rev.6/11/02) ccg 0004 in thecircuit court of cook county, illinois plaintiff...

2880 - Certificate and Motion for Default (Rev. 02/04/16) CCDR N103

IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOISCOUNTY DEPARTMENT, DOMESTIC RELATIONS DIVISION

INRE: 0 Marriage O Civil Union O Legal Separation 0 Allocation of Parental ResponsibilitiesQ Visitation (Non-Parent) 0 Support 0 Parentage of:

PetitionerNo: ieand

—|Calendar.Respondent

CERTIFICATE AND MOTION FOR DEFAULT.1, the undersigned (attorney for the) Petitioner, CERTIFY that I examined the Clerks file, docket, and computerrecord maintained in this matter on __ and found that there is proof of service of process on theRespondent by O personal service 0 substitute service on , or 0 by publication onAL + and having mailed the required notice. At least thirty (30) days have elapsed sinceservice of summons or first publication and 0 no appearance has been filed or Q an appearance has been made butno response has been filed and notice of this motion has been srved on the Respondent. Where I have indicatedQ personal service 0 substituteservice above, T also CERTIFY that I have given notice to the Respondent of myintention to request a default and to proceedto a default prove-up hearing, I therefore MOVE that the Respondent

be held in default, and that this matter be set for prove-up hearingI further CERTIFY that Tam prepared to present to the Court onthe date of hearing the following documents1. a copyofthe appropriate Petition and evidence thar all court fees have been paid:

2. a copy ofthis Certificate and Motion for Default;3. a completed Affidavit regarding Respondent's Military Service as required by 50 U.S.C. 5214. a proposed Judgment and, where an appearance has been filed, any Mariral/Civil Union Settlement Agreement

and/or Joint Parenting Agreement previously executed bythe parics which may be appended;in case of personal service, an immediate Order For Support and a Notice To Withhold Income For Supportand

6. a completed Application for Child Support Services with the IV-D Agency, where appropriate.

Arey. No.

Name: ______ EEAttorney for the Petitioner: ___ Petitioner/ Petitioner's Attorney TarSRRiAddress Bass aCity/State/Zip Code

Telephone: 2 pes4219 Order of Default |

ORDER OF DEFAULT ASSIGNMENTIT IS HEREBY ORDEREDTHATOQ Respondent is found in default Fr,QO Petitioner's motion for finding of default is denied

Dated£5 <

Judge2

Judge's No.

DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

3231 - Stipulation to Hear Uncontested Cause (12/21/15) ccIN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

COUNTY DEPARTMENT, DOMESTIC RELATIONS DIVISIONINRE: QO Marriage OQ Civil Union 0) Legal Separation Q Allocation of Parental Responsibilitics

Q Visitation (Non-Parent) O Suppore 0 Parentage ofNo.

Petitioner

od Calendar:___ ike

Respondent

CERTIFICATION AND AGREEMENT BY COUNSEL<in this cause, that all required courel is ready to proceed in this matter by uncontested prove-up as in cases of default. In cases

where a Supreme Court Rule 298 petition required 2 party to n ake payment for fees, the

partyobligated to make such pay-P pry P:

urther CERTIFY that we are prepared0present to the judge onrequired payment has been made.date of prove-up the follow documents:

a copy of the appropriate P tion and Respondent's Appearance and evidence that all court fees have been paid:est to Hear Uncontested Cause signed by da copy of this Stipulation and Ry

Ju ment ind any Marical/Civil Union Sertlement Ag and/or Parenting Plan previously executedby the partics wh ich may be appended thereto;

4. an immediate Order for Support and Notice to Withhold Income for Support; and5. a completed Application for Child Support Serv with the IV-D Agency, where

City/State/Zip Code ELTelephon : Telepho EE

Primary Email Address Primary Email Add:

condary Email Address: Secondary Email Address:

cr Email Address: Other Email Address:Od

Atty. Code No: i Lith Atty. Code No:

STIPULATION AND REQUEST TO HEAR UNCONTESTED CAUSEWe, the undersigned parties, STIPULATE AND AGREE that all matters pending between us, have been settled, agreed andcompromised, freely and voluntarily after full disclosure, and we hereby REQUEST that this cause be heardas an uncontestedmatter. We further STIPULATE AND AGREE thatOwe have waived our right to a CONTRIBUTION HEARING on the issue of fees and costs, pursuant to 750 ILCS 5/503

(j) OR

Qa CONTRIBUTION HEARING will occur subsequent to the prove-up and before Judgment.

Pecidonsr Da rTEE

pi“The original signatures of both parties are required, however, it is acceptable for the original signatures to be on separateforms.

DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOISPage 101

Order On Prove Up i i(12/18/15) CCDR Nos9


IN RE THE MARRIAGE/CIVIL UNION OF:

eT HRC| 6 4

idCalendar Lol

EEROROARE‘ORDER ON PROVE UP

This matter coming ontbe heard for (check one) Q uncontested prove up 0 default prove up on the (check one) Q Peci-tion O Counter-Petition for Dissolution of Marriage/Civil Union, (check all that apply) O PetitionerQ Respondent 0 Child Representarive/Guardian Ad Litem Q Petitioner's Attorney 0 Respondent's Attorneybeing present and the Court being fully advised in the premises, IT IS HEREBY ORDERED:

1. The (check one) Q Petitioner O Respondent shall, within _ days submit for Court approval thefollowing (check all that apply):

4566 0 Transcript of Prove UpProceedings0 Judgment for Dissolution of Marriage/Civil Union0 Settlement Agreement signed byboth parties0 Parenting Plan signed by O Petitioner 0 Respondent Q BothQ Family Support AffidavicQ Uniform Order of SupportQ Order for WithholdingQ Qualified Domestic Relations OrderQ Qualified linois Domestic Relacions Order

2. 215 Parenting Education Requirement (check ll that apply):a. 0 Both parties O Petitioner 0 Respondent has/have completed the parenting education requirement.b. QO Petitioner 0 Respondent is in Defaulc

<Q Both parties O Petitioner 0 Respondent is/are ordered to complete court approved (check one)Qin class O online parenting education program within ___ days.

dQ Parenting education is not required because the parties have no minor children together.¢.Q Parenting education requiremen is waived due to

3. 4430O The transcript of the proceedings is waived. : RE4 Q

5. 4406 O ‘This matter is set for satus on ____ a am./p.m. form. Failure to appearpresentation of the aforesaid documents and/or completion of parenting education prog

may result in vacation of the Judgment.

Au. No gi 2Name: 0 i dkfor: Q Peitioner 0 Respond

ENTERED:

Address 2: 4Dated: ____ fcMURCA

City/State/Zip Ph oe EhTelephone: Judge

DOROTHY BROWN, CLERK OF THE CIRCUIT C OURT OF COOK COUNTY, ILLINOIS

COURT REPORTER INFORMATION SHEET(Please typeor print clearly)

Date of Hearing: Judge's Name: HATitle of Case: _____caseNo. BansPetitioner or Attorney: Phone #: aimeWom ip Atty ID: BarlyPetitioner's or Attorney’s Address:

TT ja DwPetitioner's or Attorney’s Email Address:gia, chad

Respondent or Attorney: ___Phone #:po

Law Firm: Ex sie AttyID: STRespondent's or Attorney’s Address: hie rhRespondent's or Attorney's Email Address: ug alt

DateofMarriage: City/State of Marriage: pate of Separation:

Date of Service: __ Date of Publication:4 Date of Default: alin

Initials and Ages of Children: puis % ia

Maiden/Former Name:BE Nas ’ os 4

THE COURT REPORTER WILL CONTACT THE PETITIONER WHEN THE TRANSCRIPT IS READY TOBE PICKED UP. ALL TRANSCRIPTS MUST BE PAID FOR WHEN PICKED UP.

ORDER (Rev. 6/11/02) CCG 0004

IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

PlaintiffNo.

_

Defen

AFFIDAVIT AS TO MILITARY SERVICE.

__on oath states:

With respect to defendant

(the defendant is) (the defendant is not) (Tam wal

in the military service of the United States.

This affidavit is based on these facts:

TLCS 1.109 the above,signed certifies tha the statement set forth here are true and correct

4 by Law pursuant 10 7

Atty. No.

Name:

Atty.for:Address

City/State/Zip: _

Telephone


**FOR JUDCIAL USE ONLY**Prove-Up Sheet

(1125/15) CCDR 0027

UNIFORM PROVE-UP SHEETCASE No.

Gls TODAY's DATE[I DIssoLUTION OF MARRIAGE/CIvIL UNtoN [J INVALIDITY OF MARRIAGE/CIVIL UNIONrose Cont LIVIN. PetitionerProse: CIV HEIN: Petitioner's Auamey ts Comte IY [ONRespondeatinCowt [TY [IN

~~RespondemtProse [IY [IN Respondeot's AvoreymCowt [I¥ OvCourt Reporter Waived [IY [IN Interpreter Used Oy ON Focus/CIBO Completed by298 Fee Waiver OY ON Miliary Affidavit Provided [Jy [IN Opeationer [Respondent

Feiiioner RespondentName/AgeAddress Telephone

Employment

Gross Income/Net Income

Attorney's NameAddress/ Telephone

Child Rep's Name.Address/Telephone

Date of Marriage: City/State Married Date Separated:_SERVICE: [JPersonal/Date Served: ____ [Joubstitate/Date Served TFubleationDefault DateDef[Jy [IN Notice of Prove Up Sent (JY [IN Respondent's Appearance Filed (TP TJ][Grounps: Clzeconcilabie Differences: & mont separation or more. [ 1¥ [IN

RE]

[STIPULATIONS: _Uncoatested Stipulation [TY[JN. Stipulationon Signatures [TY LIN.3

1}

[AcRemars:_[TWriten Setiement Agreemacat. Dos IOI Scffloment Agroctment ]

JURISDICTIONAL Tllinois Resident for 90 Days Prior to Filing? CYLON orREQUIREMENTS: Illinois Residentfor 90 Days Prior to Today's Date? [Jy [INiOTHER: Wife Currently Pregaant? [TY [IN [] 10 resume former came ofIs there an Order of Protection (OP)? [JY [JN Ttyes, what is the status of the OP?

g

PROPERTY: Modical Insurance.&

Life Tosurance: Beneficiary: =]Real Estate/ Equity:Retirement Accounts: [Tone[TEachKeepingGv TT To ben|Debs

_____ Conuibution to Afioracy FeesMAINTENANCE: Contribution Hearing Waived:|JPetiioner [Respondent

Maintenance to ClAmount §i OReserved [Waived [Barred

L Maintezence to amounts Reserved [Waived [TBarredSTRIKE THIS SECTION 17 NOT APPLICABLE

Children's Name/AGeDOB

~~Adopted? Acknowledged? Parenting Plan [] Yes [1c Date:

_ aavon CYON ClPareotl Rosponsibiibes to. — MEOyON OvOwEsa YEN EY EINCamo Surror: [] Amomt Puidby: 0] Deviation from GuidelinesReserv Reason:“Informaon Regarding Any Addiiossl Children Should Be Attached Sepasaty

STATE OF ILLINOIS))

COUNTY OF COOK )


IN RE THE MARRIAGE OF: )

)

)))

AND D)

1)

RESPONDENT. ))

JUDGMENT FOR DISSOLUTIO:!

This cause coming on to beheard on the Petition for Dissolution of Marriage files by

Petitioner, - and it appearing to the court that the Respondent,

. was served notice of the pendency ofthis suit by publication, and has failed to

appear or answer the petition, and court having heard testimony under oath in open court in

support of said petition; and the court being fully advised in the premises find as follows

1. At commencement ofwithin action, the Petitioner resided in the State of Illinois and has

s0 resided for at least ninety (90) days prior to the findings herein.

2. The court has jurisdiction of the petitioner and the subject matter hereof.

The parties were lawfully married on ; and the certificate was

registered in Cook County, State of Illinois,

4. There were no child(ren) bomto the Parties. No other children were bornor adopted

during the marriage. Petitioner is not pregnant

5. Petitioner by competent evidence has met the grounds of irreconcilable differences.

I'HEREFORE, BY VIRTUE OF THE STATE OF ILLINOIS AND ON MOTION

OF THE PETITIONER, IT IS HEREBY ORDERED:

ent of Dissolution of Marriageis awarded to the Parties. Accordin

the bonds of matrimony existing between Petitioner

and Responden , are hereby dissolved, andthe Parties, cachofthem is, freed from theobl ions thereof, and are herewith divorced from each

other

That all property matters, including maintenance, are reserved

C. That this Court shall retain jurisdiction of this matter until the terms of this

judgment for dissolution of marriage have, inall respects, met full compliance

Enter.

JUDGE

Address

City/State/Zip:

Telephone

Atty No: 99500

3149- Motion4209 - Order (Rev. 12/18/15) CCDR N030


INRE: O Marriage O Civil Union Legal Separation 0 Allocation of Parental ResponsibilitiesQ Visization (Non-Parent) 0 Support 0 Ps tage of:

—|Mo.Petitioner

and

Calendar

pondent

MOTION FOR APPOINTMENT OF SPECIAL PROCESS SERVER

Petitioner moves this Court to order service of process in this cause tobe made by the following individual, who is overhice and not a party to this cause:

NAME:

ADDRESS

I. The appointment of 2 special process server will fcilitare the administration of justice.

Arty. Code No.

Auy. Si

Name

y/State/Zip Code: __Telephone: ___

ail Address:Primary E:

y Email Address:Secon

Other Email Address:

ORDER APPOINTING SPECL "ROCESS SERVER.

IT IS HEREBY ORDERED thaointed to makes

18 years of

ageand not a partyto

with the Clerkofthis caus: ocess in this cause and ro fil it of proof of servicof the Circuit Court immediacely therea

ENTERED:

Dated:


This form Is approved by the llinois Supreme Court and is required to be accepted In all linois Circuit Courts.

STATE OF ILLINOIS,E

JUDGMENT OF DISSOLUTION OFCIRCUIT COURT < EG)|

:

|MARRIAGE / CIVIL UNION Esa AIS| COOK COUNTY | (DIVORCE NO CHILDREN)

Instructions __|[ER————

Petitioner(Fst, middle, st rama)[Baer your same as

Respondent[a[Do NOT complete A court date was held on the Petition for Dissolution of Marriage/Civil Union filed by the Petitioner.

this section. The judge1 Thejudt|The court heardthete imony of [#* Petitioner [&*Respondent and considered f the

| waIr evidence and the relevant parts ofthe linois Marriage and Dissolution of Marriage ActDONOTomgiee la|(750 1LCS 5/101 )

22d 1b. The jul

The Court makesthe following findingsoffact:1. Present in Court

a. Petitioner appeared: [Yes[0] represented by Attomey

b. Respondent appeared: [B—Yes [J No

OO represented by Attorney:

2. Jurisdictionfive du, you camer a. This court has jurisdiction of matterand BF Petitoner [B-Responcent

es [BE Norently on active duty as a men

O Yes @ Ne O

Toute 3. AgreementPar th the termsofthare in agreement dan

4. Residency Requirementa been living in llincis at least 90 days immediately preceding the fling of

immediately proceding the making of thgs:

[X Yes No

5 thas been livingin llinois at least 0 days immediately preceding the filing

fon or immediately preceding dings: [@ Yes [1 No

5. Information about the: Marr

a. Parties were marriec/united on : Sgro

Eris the Case Numser gen oy ne Grout

6. Grounds for Dissolu nImeconcilable differences have caused the irrstrievable breakdown of the mariage or civil

union and efforts at reconciliation have falled or future attempts at reconciliation wouldbe impr le and not in the besti erests of the family.

7. There are no children born or adopted of this marriagelcivil union and neither partyis pregnant.

5. RealEstatePart Al union:

zris Judgment

narital real estate: ® No

Non-Marital Real Estate form.

9. Maintonance/Spousal Supporta These parties have waived the right to maintenancelspousal support

EFORE, IT IS ORDERED, ADJUDGED AND DECREED AS FOLLOWSA. The parties are awarded a Judgment of Dissolution of Marriage/Civil Union and the

bonds of matrimony/civil union existing between Petitioner and Respondent arehereby dissolved.

B. Debts and Liabilities

This form is approved by the liincis Supreme Court and Is required to be accepted in all lino Circuit Courts.

STATEOF ILLINOIS,CIRCUIT COURT ADDITIONAL DEBTS & LIABILITIES

DISSOLUTION OF___

COOK COUNTY MARRIAGE/CIVIL UNION

Fatitioner

Case Number

] oor

1

This form is approved by the llinols Supreme Court and is required to bs accepted in ail llinois Circuit Courts.

STATE OF ILLINOIS, ADDITIONAL PERSONALCIRCUIT COURT PROPERTY & BANK ACCOUNTSAe (DISSOLUTION OFSergi span MARRIAGE/CIVIL UNION;

Instructions v

Case Number |

Do NOT Property goes to.

[Parties shall indemnity and hold the other party harmless for the debts they are assigned

DONOT compl C. Pension and Retirement Accounts

epi [J Petitioner is awarded3 % ofthe marital/civil union portion of

Respondent's pensioniretirement accounts.[1] Respondent is awarded ___

Petitioner's pensionretirement accounts.] Petitioner Respondent shall prepare a Qualified Domestic Relations Order

Other orders

% of the maritalicivil union portion of

DONOT complete.|D.

to shall besoldsale (sale price minus costsofsale) shall be divided with

4 Respondent to receive@ is sold, me] Until the marital real ests gage payments will be paid by

[] Petitioner% [J Respondent %

[Until the marital real estate is sold, insurance wil be paid by [] PetitionerRespondent _%[J "Until the marital ate is sold, cost of maintenance will be paid by [] Petitioner

[10Petiioner [J Resp t shal sign a quitiaim deed transferring hismer

interest to the other party by 5OtherhoePersonal Property and Bank Accounts

Property goes to:

Petitioner|Respondent

wer the Case Number given by theFurniture DiningSet

erty exchange requires Judgment.

DONOT comp 7. Maintenance/Spousal SupportTheindgo vit, [BBartiesare forever barred fom claiming maintenancs/spousal support from the other.a = [7]

Petitioner shall pay to Respondent maintenance/spousal support inthe amount of

5 ares oe __for the following period:

after which maintenance/spousal support shall be[]barred or [hall pay to PetitionerJ Respondent aintenance/spousal support in the amount

s eh ped for the following periodafter which maintenance/spousal support s [J tamed or

E

1 This court reserves jurisdiction over the parties and the subject matter for purposesof enforcing this Judgment.

pONOT ENTERED!

STATE OF ILLINOIS))

COUNTY OF COOK )


i; s OuverceIN RE THE MARRIAGE OF: ) Sarda RN eS© EN nana A

)

)

PETITIONER, )

)

AND JET CA) Ca

RESPONDENT )

)

JUDGMENT OF DISSOLUTION OF M

This cause coming on to be heard on the Petition for Dissolution of Marriage filed

by the Petitioner, andit appearing to the Court that the

Respondent, was served notice of the pendency of this suit by

proper service of Summons and hasfailed to file an appearance and/or answer fo the

Petition andthe Court having heard testimony taken under oath in open court in support

ofsaid Petition; the Court being fullyadvised in the premises, finds as follows:

1. That this Court has jurisdiction ofthe parties and the subject matter of this cause.

2. That thePetitioner was domiciled in the State of Illinois at the commencement of

this action and has been an actual resident of this State for a period in excess of

ninety days immediately preceding the making of these findings.

That the parties were lawfully joined in Marriage on the day of

and the Marriage was registered in the County of Cook , State of Illinois.

4.

6.

THEREFORE, BY VIRTUE OF THE STATUTES OF THE STATE OF II

That there was a child born to the Parties, namely who is now

years of age, no children were adopted and the Wife is not now pregnant.

a. That neither Petitioner nor Respondent hasa legal interest in real estate.

That the Petitionerby competent evidence has met the grounds of irreconcilable

differences.

INOTS AND

ON MOTION OF THE PETITIONER, IT IS HEREBY ORDERED:

B.

D.

That the bonds of matrimony heretofore existing between Petitioner,

+ and Respondent, , be dissolved as to both

Parties.

Except as otherwise stated herein, each party is awarded those items of person

property that are now in their possession as their property without claim of the

other party.

Except as otherwise stated herein, each party is liablefor the debt incurred and/or

entitled in their own names and hold the other party harmless of all liability

associated with said debt.

Except as otherwise stated herein, each party is rded-any interest they may have

in any pension or retirement plan registered in their own name.

i. Maintenanceis barred as to both partics.

F. That Petitioner and Respondent shall execute and acknowledge, upon the effective

date of this judgment, good and sufficient instruments necessary or proper to vest

the titles and estates in the respective parties as provided in this Judgment. If eitherparty hereto for any reason shall fail or refuse to exccute any such document, then

this Judgment shall, and it is expressly declared, to effect a conveyance of all rights

inthis Judgment designated tobe transferred, assigned and conveyed and a full,

present and effective and waiver of all rights hereinabove designated to be

relinquished and waived

G. That the Wifeis granted leave to resume use of her former name, Staples.

H. That this court expressly retains jurisdic on of this cause for the purpose of

nforcing all the terms of this Judgment of Dissolution of Marriage.

ENTER:

Judge

Name:Attorney Code No.: 99500AddressCityTelephone Number:

Personal Service -Agreement or Default

COURT OF COOK COUNTY, ILLINOISMENT - DOMESTIC RELATIONS DIVISION

_UNION OF: )))) CASE NO.)

) CALENDAR:))

)

JUDG! OF MARRIAGE/CIVIL UNION

“This cause coming on to be heard for prove up on the Verified Petition for Dissolution of

Marriage/Civil Union, Self-Represented Petitioner appearing and (check one): C1 personal

service having been had on Respondent and Respondent having been found in default; or@the

Respondent having filed an appearance on his/her own behalf and the parties being in agreement.

The court having heard the testimony of (check one): Petitioner CIRespondent @Both

Parties, hereby FINDS:

1. Respondent (check one)[1did CJ did not appear in court.

2. The court has jurisdiction of the partics and the subject mater.

(Check if applicable) @ The court has jurisdiction over the child(ren) pursuant to Uniform

Child-Custody Jurisdiction and Enforcement Act.

3. At least oneof the parties was a resident of Illinois on the date the action was filed or

for 90 days preceding the maki of these findings.

4. The parties were married/obtained a civil union on____ er (date)

in Chicago IL ___ (city and state) or (country)

The grounds of irreconcilatedifferences have been proven by competent testimony

6. (Check one

No children were born to or adopted bythe parties.

7) The following children wereborn to or adopted by the parties:

NAMI DATE OFBIRTH

a 12006

bs 12007 fon

pe 12008of

dor [0TZEEET 28e 12013

7. (Check all that apply).

1 Petitioner is preg

[J Respondent is pregnant.

Neither party is prognant

Based on the competent testimony transcribed for the record and the evidence received,

IT IS HEREBY ORDERED

A Dissolution of Marriage/Civil Union and

dsof

m on between Petitioner and

B.

The : part of this Judgment

and all provisions of it are express! confirmed, approved and adopted as

the order of this court. Fach of the perform under the terms of said

Parenting Plan

he parties have no minor children.

C. CHILD SUPPORT (check or

r pay

C [Respondent child

D. CHILD(REN)'s HEALTH EXPENSES (check o

Petitioner [J O Both OO Neither shall provide health

the child(ren). All medical, dental, psychological and visioninsurance for

___ %by Petitioner andexpenses not covered by insurance shall be paid

ndent

erage is reser

0 The parties have no minor children

all maintain the child(ren) as irrevo

unt of: §___ untilbeneficiaries of their life insurance, in the

the child(ren) are emaricipatedor complete college per st.

The parties have no minor children,

d(ren)'s post-high school educational expenses are reserved and shall

be determine

¥ Respby Petitioner

The parties have no minor children.

MAINTENANCE (check

allthat apply

Olpetitioner or CIRespondent shall pay to ClPetitioner or

r maintenance

Except 2 ded herein, each party is awarded all propert

wn names and in their own possession and control

Petitioner is awarded the following property

Respondent is ay

DIRespondent

n their

K. rein,

and all debts in

This court ¢ for the purpose of enforcingall of the terms of this Judgment for DissolutionofMarriag Civil Union.

Each party wil forgo any p tion or interest other party's retirement

ENTER:_ sy >

JUDGE

ADDRESS £ As aCITY, STATE, ZIP ieTELEPHONEATTORNEY NO. (Self-Represered code) 99300

Child Support Obligation - Basic Child Support - Worksheet A

case no.5 minor children Note: Initials not necessary Per SCR 138

Mother's Father's CombinedNet /Mo. Net/ Mo. Net/ Mo.

1. Monthly Net Income - Dollar amount *

$0, $707 $7071a. Minus child support payments for otherchildren - Dollar amount - See Sec.505(2)(3)(F)2. Monthly Adjusted Net Income - Dollaramount

= [izim iShould3. Percentage Share of Income - % 100% 100%| dq upto~ 100%

4. Basic Combined Obligation - apply line 2 &W'=D S9PPWT. hi

obuGATed iy Bath)Combined Net Figure to Income Shares, Seamer] MIN mo.Schedule based on number of children s€¢ 150 zen 5/595 (339)Dollar amount $120]

5. Each parent's share of child support T

T

1

should

obligation **, *** |

$0 $120] Sep)da* To arrive at line 1 net amounts, take gross income, subtract maintenance paid (or add maintenance received)per Sec.505(3)(3)(F). Then subtract taxes [standardized or individual see Sec. 505(a)(3)(8)]. Any necessarybusiness deductions per Sec. 505(a)(3.1) are applied at this stage. Any potential income per Sec. 505(a)(3.2)(unemployed or underemployed) would apply here, too.** The obligation of the parent awarded the majorityof the parenting time (formerly the "custodial parent”) isassumed to be used in the course of everyday expenses for the child/ren and is retained by that parent.*#% The parent not allocated the majority of parenting time (formerly the "non-residential parent") pays childsupport per line 5 above.

Electronic Excel Version Createdby Attorney Stephanie A. Kasten based on worksheets originallycreated by Attorney Margaret A. Bennett

Attorney Stephanie A. KasteThe Gitlin Law Firm, P.C.

0 Motion to Provide Moc Ivarsmce AlowedSIT

©Order Arrearage St (omeent soviet) AiredProduce Ekibi or ster certs o Doctments o Pern - Alowed 456

©Order For Ch Support Abomed

Sirike te Wiebe Maso o Fein Bowed 55

©OrterTomperary Maemmmte Allowed

‘Child Support Order Above Seattory Gotdeins Allowed wn Order Support Payments Made Dirct 1 C.C.C ADU. AllowsCh Support Order Beto Suto Gotdlns

—Amed S00 Oras Soper ment Made Die b Rpemdre Aled


UNIFORM ORDER FOR SUPPORT© Initial Order Modification CO Enforcement UIFSA

EC fo =F

Docket No.Petitioner/[JObligee Z0bligor rT =IV-D No: €

fispai Calendar No. ile

Respondent B) Obiiges ob O Hlinois Department of Healthcare and FamilyServices is, or has been, granted leave to intervene.

Definitions: Obligor - An individual who owes a duty to make support payments pursuant fo an Order for SupportObligee ~ An individual to whom a duty of support is owed or the individual's legal representativePayor — Any payor of income to an ObligorUnallocated Support A total amount for maintenance and child support and not a specific amount for ther

THIS MATTER coming o be heard on Petition for > Rule andor Modification Support =udgment bt Oris, +1 PavingThe Court Finds

The Court has jurisdiction of the parties and the subject matter and that due notice was given byjb

© 2) The net income of the Obligor is § xy

Tb) The amount of arrearage/judgment for child support is S asof (au, interestiss aso au. |] terest prior to January 1, 2000, is reserved,enance or unallocated support is § as of aa) and/or medical

“an gE Taste© The amount of child support cannot be expressed exclusively 4s dolla amount because all or a portion ofthe Obligor's net income is uncertain as to source, time of payment, or amount.

Od) Retroactive child support is S__ from ___ ©

The=Obligee©Obligee’s Attorney © Obligor © Obligor's Attorney©Assistant State's Attorney, being preset“This matter being an Interstate Case, © Voluntary Acknowledgement of Paternity was signed onItis Ordered:©After hearing 2 By agreement of the parties © By default that.

Obligor, is to provide

© MAINTENANCE (DDPayment AmountCurrent Maint nee: 5 every weekArrearage Payment

© monthly© twice each month on

AHa,

Payments Begin O other 3 (date)CHILD SUPPORT OR © UNALLOCATED SUPPORT 55

Payment Amount Payment FrequencyCurreat Child Support Payment orUnallocated Support Payment:

~~§ 5 ii © every week @ every other week monthly

Arrearage/Retroactive Payment: §Otwice each month on__ aiseOther Payment s other __ Ei (ate)Payments Begin: (date)

Judgment in the amount of S____ plus interest ofS fora total due of §__is entered against the OD]

—_— — _—© PERCENTAGE AMOUNT OF CHILD SUPPORT (Complete this section only if finding (¢) is checked above.)

[n addition to the specific dollar amount of support ordered above, current child support shall be paid in the amount of_%of Obligor’s payable The Obligor is

further ordered to provide income records sufficient to determine and enforce the percentage amount of child supportwithin 7 days of receipt of income subject to this percentage assessment, to the 0) Obligee and 0) Clerk of the Court.

4 ADDITIONAL CONDITIONS OR FINDINGS

idelines. The amount ofChild support payment amount deviates from the amount required by statutory minimum

support that would have been required under the guidelines is §

Reasons for deviation:Dass poor

Child Support is based on the needs of thecThe Child/ren covered by this Order is/are:

Month/Year of Birth;

E 9]Month/Year of Birth;

5 Month/Year of Birth:

fi" Month/Year of Birth;

PAYMENT ARRANGEMENTS

(Payments must be sent to the STATE DISEURSEMENT UNIT if this box is checked)

A Notice to Withhold Income shall be issued immediately and shall be served on the employer at the address listed in thisOrder. Payments shall be made payable to the State Disbursement Unit and sent to the State Disbursement Unit at P.O. Box

400, Carol Stream, IL. 60197-5400. Payments must include CASE NUMBER, COUNTY of the Court issuingthisOrder,and Obligor's name and social security number. Any subsequent employer may be served with a Notice to Withhold Incomewithout further order of the Court,

In addition to and separate fro unts ordered to be paid as maintenance or child support, the Obligor shall pay a S36per vear Separate Maintenance and Child Support Collection Fee. This sum shallbe paid directly to the Office of the Clerkof the Circuit Court, Child Support Division. Richard J. Daley Center, 50 West Washington Street, Room LLOL, Chicago, TT

60602, and not to the State Dis arsement Uni

DELINQUENCY

If the Obligor becomes delinquent in the payment of support after the entry of this Order for Support, the Obligor must pay.in addition to the current support obligation, the sum of (a) § 11.08 for delinquent child support per thepayment frequency ordered above for child support, and (b)S__ for delinquent maintenance orunallocated support per the payment frequency ordered above for maintenance or unallocated s

delinquency is paid in full. (This additional amount, the total of (a) and (b), shall not be less than 20 percent of the total ofthe current support amount and the amount to be paid for payment of any arrearage stated in the Order for Support, A

support obligation, or any portion of a support obligation which becomes due and remains unpaid for 30 days or more, shallaccrue interest per annum.

Docket No.

SAO 2500.1 Rev.

TERMINATION

This obligation to pay child support terminates on [|the child [] youngest child's 15* birthdate unless modified by writtenorder of the Court or uniess the child is still attending high school afterattaining the age of 18, then the termination dateshall be the earlier of the child's high school graduation or the date on which the child will attain the age of 19. Thistermination date docs not apply (o any arrearage that may remain unpaid on that date.

ARREARS PAYMENT

If on the termination date (If no termination date, then on date the child attains majority or otherwise emancipates) there isan unpaid arrearage or delinquency equal to at least one month's support obligation, the amount being paid immediatelypreceding termination, including any current support payment, arrearage payment and/or any delinguency, will continue tobe collected as an obligation, not as current support, but as a periodic payment toward satisfaction ofthe unpaid support.MEDICAL INSURANCE

The OD Obligor, © Obligee.

previous order entered on__

through the C Obligor’s,©Obligee's,CObligor’s and Obligee's, employment or © by securing a private health insurancepolicy, accepted by the Obligor and Obligee or approved by the Court, which names the child(ren) as beneficiary. TheObligor shall provide to the Obligee a copy of the insurance policy and the insurance card within 45 days. The employer orlabor union or trade union shall disclose information concerning dependent coverage plans whether or not a court order formedical support has been entered. 750 1S 505.2

Obligor and Obligee, shall provide health insurance for the child(re© by enrolling them in any health insurance coverage available

as provided in

oO The Obligor is liablefor “% of medical expenses

© Upon obtaining employment which provides dependent health hospitalization insurance at reasonable costs: orupon Obligor’s employer making dependent health hospitalization insurance available at reasonable costs, Obligorust immediately enroll the aforementioned child(ren) in the employer's health hospitalization insurance plan.

Ihe issue of medical insurance is reserved/withdrawn.

curred by the nor child(ren) and not covered by

It s further ordered that (except when the Court finds thatthe physical, mental or emotional health of a party or that of aminor child, or both, would be seriously endangered by disclosure of the party's address).The Obligor shall give written notice to the Clerk of the Court,andJf a party is recciving child and spouse services underArticle X of the Hlinois Public Aid Code, to the Hlinois Department of Healthcare and Family Services, (HFS) within 7 days.of:

«any new residential, mailing address or telephone number+ the name, address and phone number of any new employer, and;+ the policy name and identifying number(s) of health insurance coverage available.

The Obligor shall submit a written reportof termination of employment and of new employment, including name andaddress ofthe new employer, to the Clerk of the Court and the Obligee within 10 days. Obligor and Obligee shall advise cachother of a change of residence within 5 days except when the Court finds that the physical, mental or cmotional health ofparty or that of a minor child, or both, would be seriously endangered by disclosure of the party's address. An Obligeereceiving payments through income withholding shall notify the Clerk of the Court and the State Disbursement Unit within 7days, of a change in residence. The Obligor and Obligee shall report to the Clerk of the Court any change of inform:included in the Child Support Data Sheet (Exhibit 1) within 5 business days of such 4 change.UNEMPLOYMENT

1) Obligor is unemployed andis ordered to seek employment. The Obligor must report periodically to the C with a diarylisting the name, address, telephone number and contact person of cach employer with which he or she has so ght

© Obligor is ordered to report to the Department of Employment Security for job search services or to complete anapplication with the local Job Training Partnership Act provider for participation in job search, training or work programs.© Obligor is unemployed and is orderedto put forth a diligent effort to obtain employment and to cooperate with allinstructions of HFS. The Obligor is ordered to report immediately to the HFS Non-Custodial Parent Support Services Unit,36 South Wabash, 9* Floor, for assessment and assignment into the Court monitored Job Search program or Earnfareprogram. Upon finding employment, the Obligor shall notify HFSin writing at 36 South Wabash, 9" Floor, Chicago, IL 60603within 7 days. The Obligor must submit the name and address of the employer, the start date, andthe rate of pay to the HFSNon-Custodial Parent Services Unit. The Obligo to comply with the requirements of this Order may result in theState's Attorney seeking a contempt of court order. (Note: Earnfare requires a $50.00 minimum support order.)

s ail

Docket No. IV-D No,

SAO 2500.1 (Rev. 0117] Paee3ars

—_ —_— _—_ —0 GENETIC TEST REIMBURSEMENT: Obligor shall pay § to TIFS for a genetic testreimbursement. Payments must be made in lump sum or installments by personal check or money order payable to HFS andcither mailed to: TIF, Title IV-D Accounting Unit, P.O. Box 19138, Springfield, IL. 62705-9138, or conveyed as otherwisedirected by the Court. Payment must include IV-D number as shown on this Order.

_—oo‘This Order does not preclude HFS from collecting any arrearage established by or which may accrueSupport by use of the offset provisions of Section 6402 (c) of the Internal Revenue Code of 1954, and 15 ILCS 405/10.05(a) asamended. Such arrearage shall be considered as “past due” or “due and payable” within the meaning of said statutoryprovisions. This order does not preclude the placing of a lien on real and personal assets or initiating a proceeding forgarnishment, attachment of sequestration pursuant to law and the Code of Civil Procedure.

This order of support supersedes any and all prior orders of support under this case number.

© OTHER: ___ 2 —

> This causeis continuedfor Sh hia atm. Room at

© RichardJ. Daley Center, 50 W. Washington, © Richard J. Daley Center, 50 W, Washington,Chicago, 11 Concourse Level~Room CL24, Chicago, IL

7 District 2 5600 Old Orchard Road, Skokie, IL © District 5 10220 South 76* Ave., BriDistrict 32121 Euclid Ave., Rolling Meadows,

0 District 6 - 16501 South Kedzie, Markham, ILIn

© District 4 1500 Maybrook Drive, Maywood, IL

without further notice without further notice to Petitioner without further notice to Respondent

FAILURE TO APPEAR MAY RESULT IN ENTRY OF A DEFAULT JUDGMENT

Docket No. IV-D No.SAO 2500-1 (Rev. 0017] Pagedors

© FOR EXPEDITED CHILD SUPPORT CASES ONLYz

NOTICE OF RIGHT TO REQUEST A JUDICIAL HEARING: You have a rightto request a Judicial Hearing, If eitherparty does not agree to the recommended Order or any part thereof, this case will be transferred for an immediate JudicialHearing.

This Order may be vacated or amended within 30 days of is entry. This Order is not valid until signedby a judge.

So recommended © the Court this... dayof J_

HearingOfficers Gena.

Respondent’ Obligor's SignaturePetitioner) Obligee's Si

Petitioner] Obligee’s Attorney's Signature Respondent’ Obligors Attorney's Signature

FAILURE TO OBEY ANY OF THE PROVISIONS OF THIS ORDER MAY RESULT IN A

FINDING OF CONTEMPT OF COURT

Date Judge Judge's No,

KIMBERLY M. FOXX #17052State's Attorney of Cook County

By Pp

Assistant State's Atioruey (Attorney for 117)28 N. Clark St. Suite 300

Chicago, linois 6060:312) 3462200i6 Docket No. 1v-D No.

f 14

ORDER,IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS

DOMESTIC RELATIONS DIVISION

Petitioner,

No.

Cal.

Respondent.

PARENTING PINOTE 10 PARTIES

must submit some form of a written Parenting Plan to the CourtPla

ponsibilitie n-making and parentingsubmit to the Court. This form does not include every

se. If you wish to address issues that are not includedin this form,you may address thoseissues in the sections marked “Other”.

clevant to thefactse allocation of parentas a Parenting Plan t

possible issue that may be relevant in your

ten Parentcertain provision

time. You may use this form

ong parties where the children are jointly cre: a writte2 join own wri

Court must enter it d by oneWhether the Court approves your plan or enters its own, the Parentin

payou must each file yowritten Parenti

own plan which may be a planhe parties or may be entirely dif

Plan will become a Court Order.

This is a:

Plan (we agree 10

eve

2 Plan (we agree 10 some I

n prepared by oneparty (there is no ¢

[7] Full Joint Parenti{1 Partial Joint ParentI] Parenting PL

igs and the p

reement betwee 1 the parties)

If this is 2 partial joint Parent a Parentithe court the Pretrial Statement to identify issues

Plan prepared by one party, please complete and file withyou have no on. This is a required form a

eed upon

of 14)

PETITIONER INFORMATION

The Petitioner is the child(ren)’s] Father |] Mother

[—]Other party onship to child(ren) 3

The information below is required unless one of the following two boxes is checked:

history of domestic violence or abuse] Petitioners information omitted duomitted beca use disclosure of such information is not

Residential address:Home phone number:Cell phone number: ____N

Employer addressEmployer phone number: _The above person shall be referred to as “Petitioner” throughout this Parenting Plan.

RESPONDENT INFORMATION

The Respondent is the child(ren)'s

|] Father [7] Mother [—] Other party (sate relationship to child(ren)

The information below is required unless one of the following two boxes is checked

Respondent's inf tteded because disclosure of such information is n

¢ to history of domestic violence or abuse{ 1 Respondent's information omi[

in the bestof the child(ren) or pares

Residential ad

{ome pho

Nar of empEmployer address:

Employ, one number:

The above person shall be referred to as “Respondent” throughout this Parenting Plan

of 14

CHILD(REN)'S INFORMATIO]

Genderof child

below unless one ofenrollment purposes only shall be|dential a hethe following two boxes is checked:

[ ] Child(ren)’s address omitted due to history of domestic violence or abuse[ ] Child(ren)’s address omitted because disclosure of such information is not in the best interestof the

child(ren) or parent.

Address

Address

CHANGE OF ADDRESS AND/OR PHONE NUMBERS

hange in address or phone number as set forth below unless one of theParties shall notify one anfollowing two boxes is checked:

[ 1 Not required due to history of domestic violenceor abuse.1 Not required because disclosure of such information is not in the best interest of the child(ren) or

parent

CHANGE OF ADDRESS: ent hasa chent at least 60 days prior written notice. If it is no

he pa I notify the other parent as soon asand the new addres:

2. CHANGE OF PHONE NUMBERS: If a parent has a change of heme, cell or work phonenumber, that parent shall notify the other parent as soon as possible of the new number

ent moving sh

(initials)

Paged of 14

ALLOCATION OFSIGNIFICANT DECISIO.

(RENTAL RESPONSIBILITIESMAKING RESPONSIBILITIE

ow who will be respindicate bthe child(re

CATION:

cant decisions regarding the

11 Petitioner will11 Respondent wi

HEALTH:

icant decisions regarding the child(ren)’s health 10 the medical, dental, andthe child(ren) and to the treatments ar

[7] Both parties w

[1 Parties will di

Respondent will make

cisions regarding healthealth.

[7] Petitioner will make all significant

1 Respondent will make all significant decisions regarding

RELIGION

[7] Both parties will make all significant decisions regarding religion together.F Parties will divide the as follows:

[1 Petitioner wil

Respondent4[1] Parties ot &

PageSof 14

EXTRA-CURRICULAR AND RECREATIONAL ACTIVITIES:

Significant decisions regarding the child(ren)'s extra-curricular and recreational activities:

Please select one1 Both parties will make all significant decisions regarding extra-curricular & recreational activities together.I] Parties will divide thesignificant decisions regarding extra-curricular & recreational activities as follows:

[1 Petitioner will make the following decisions regarding extra-curricular & recreational activities.

ar & recreational activities[| Respondent will make the following decisions regarding extra-curric

I] Petitioner will make all significant decisions regarding extra-curricular & recreational activities.11 Respondent will make all significant decisions regarding extra-curricular & recreational activities

OTHER:

Any other significant decisions regarding the child(ren) parties wish to include that have not been set forth above:

[J Both parties shall make all significant decisions regarding the issues above together.F Parties shall divide the significant decisions regarding] Petitioner will make the following decisions:

[1 Respondent will make the following deci

he issues abovehe issues above

[7] Petitioner will make all significant decisions regardI Respondent will makeall significant decisions regards

Parties shallsetforth the times that the child(ren) will be with each party. When a party has the child(ren) forparenting time, that party shall be responsible for making day-to-day decisions and for providing care-takingfunctions for the child(ren). The definitions under Iilinois law of “parenting time” and "care-taking” functionsmay be found in the Addendum at the end of this document,

PLEASE SELECT AND COMPLETE ONE OF THE FOLLOWING FOUR (4) PARENTING-TIMEPLANS.

1. [+] REGULAR PARENTING TIME: The parties will have the same parenting-time schedule that reth onth. If you have chosen this option, please compete the parenting-time schedule set forth onthe following page and indicatethe date upon which the parenting time will begir

ghout n

(initials)_

WHO HASCHILD(REN) |

|

PetitionerRespondent|IPetitioner||Responde

PetitionerRespondent

[THUR |7Petitionerspondent

[7 Petitioner|

|) Resp

|1) Respondent|I[SIN [ET

REGULAR PARENTING SCHEDULE

FREQUENCY

J Every] Every

week1 Other

J Every] Every

} Other

PO TF YES,PARENTS

| TIME OFEXCHANGE|EXCHANGECHILDREN |

THIS DAY? |

week |] Yes [Eenother | |

1 No PM

Week£

other |

EveryEvery

] Other

| Fr Every] Every

Other

EveryI~] Every

week] Other

J Every

Everyweek

J Other

EveryEvery

Othe:

week |] Ye AM

1 No PM

|

wi|

| ™ |

|

week [7 Yesothe a1 No i ag

|

=

|

week|AM |

other

1 No mM

weekSee ea]

PM

Page 6 of 14

EXCHANGE & WHOWILL PROVIDETRANSPORTATION

of 14

[| PARENTING TIME BASED ON CHANGING WORK SCHEDULES: At least one party does not havework schedule and it is not possible to set a regular schedule. Parties must create some fype of

“formula” for howthey will decide on each party's parenting time. Please complete the following:

Parties will set their parenting time as follows:

Transportati

[ ] Petitioner~~[ ] Respondent [ ] Other please speciwill provide transportation a! the beginning of the parenting time andthe locatiothe child(ren)shall be:

the exchange of

[ ] Petitioner [| Respondent [ ] Other pleasespecifwill provide transportation at the end of the parenting time and the locationof the exchange of thechild(ren) shall be

[ ] LONG-DISTANCE PARENTING TIME: Parties live a long distance from one another and it isnot possible to set a regular schedule. Please complete the following:

The long distance party shall have parenting time as follows:

Transportation:1. At the beginning of the parenting times:

i. [ | Petitioner | | Respondent shall arrangefor and provide transportation for thechild(ren)

ii. [| Petitioner | ] Respondent will be responsible for any costs associated withchild(ren)'s transportation, or parties will share the costs of transportation asfollows

iii. Location of the exchas2. At the end of the parenting times:

i. [ ] Petitioner [ ] Respondentild(ren)

ii. [] Petitioner [ ] Respondent will be responsible for any costs associated withchild(ren)’s transportation, or parties will share the costsof transportation asfollows:

iii. Location of the exchange of the child(ren) shall be

of child(ren) shall be

| arrange for and provide transportation for the

(initials) _,

of14

Child(ren) shall have the following electronic/telephonic communication with the long-distanceparty as follows:

4. [/] OTHER: Parties agree to the following alternate parenting schedule. The followingschedule must include a specific schedule or formula for parenting time, transportationarrangements and location(s) of exchanges of child(ren).

Pare;notice

greed that Dad may have parenting time with his children as long ashe givadvance and there is no scheduled event or activity already planned for the day or days dad has picked.

for parenting time.

That transps he childrenforDad's parenting ime with their children for pickupanMom because Dad doesn't have transportation.

op off will be on

ADDITIONAL PARENTING TIME

SCHOOL BREA!

WINTER BREAK:

Child(ren) will be with PetitionerChild(ren) will be with RespondentTime and place of &

-or- [+] Parties will keep th ir regular parenting-time

SPRING BREA

Child(ren) will be with PetitionerChild(ren) will be with RespondentTime and place of exchanges ia-or- [+] Parties will keep their regular parenting-time sch

SUMMER BREAK:

Children) will be with PetitChild(ren) will be with Respondent

g

Time and place of exchanges-or-[+] Parties will keep their re ilar parenting-time schedule:

(initials)

of14

VACATIONS:

[+] Each party shall be allowed to take the child(ren) on vacation for 7

__consecutive / non-consecutive

circle one) days eachyear.1. The traveling party shall give the other party at least 1

___ days’ notice of travel.The traveling party shall provide the other party with a written itinerary of travel prior to

traveling. Such itinerary shall include at a minimum, dates of travel, travel destination(s),flight numbers and tims, and contact addresses and phone numbers while traveling

] Any conditions or restrictions regarding travel by cither party

HOLIDAYS:

Parties may set forth a holiday schedule in the chart below or select oneof the options that follow this chart.The holiday schedule shall supersede the regular schedule. Please leave blank those holidays not celebrated by

youandthe other party or those not in need of 2 schedule separate from the regular parenting schedule set forthabove.

HOLIDAY PETITIONER|RESPONDENT TIMES & LOCATION OFGEEXCHA

[Tabor DayJuly 4°

Child(ren)'s Birthday[Petitioner's Birthday[Respondent's Birthday

of 14

[+] HOLIDAY SCHEDULE BY MUTUAL AGREEMENT: Both parents shall be able to spend time withthe child(ren) on the holidays and parents will mutually agree to specific arrangements as cach holidayapproaches

[ ) OTHER:

ADDITIONAL PROVISION

TRANSPORTATION REQUIREMENTS

Each party shall insure that wheneverthe child(ren) are being transported in a vehicle, the driver of that vehiclehasa valid driver's license and insurance and that the child(ren) are sccurcdin proper car seats or seatbelts asrequired by Tllinois law

CHANGES TO PARENTING TIME OR ALLOCATION ¢

RESPONSIBILITIESIGNIFICANT DECISION. AKING

If eitherpartywishes to make changes in the parenting time orresponsibilities set forth

es cannot agree on

gnificant decision-makih mutual discussion.

ies will seek the assistance of a neutral third party, such as aunsclor or trained mediator, such as the Center for Conflict Resolution 312-922-6464

Parties will return to court only as a last resortprofessional c

NOTE: If oneof the parties has been allocated all significant decision-making authority underthis Parenting Plan, parties are not required to follow this provision.

ATION OF CUSTODIAN

ne person be designated as the custodian of the child(ren)federal statutes requires the designation of a custodian or606.10 provides that where a

ion of custody, the party who has he majority of the parentingf state and federal st

me shall be designated thestodian solely for the p tutes.

The desi on of custodian shall not y way either party's rights and responsibilities as setin this Parenting Plan.

Please se the boxes below regarding designationof custodian[1 Petitioner has the majority of the parenting time under the parenting schedule set forth

above, shall be designatedas the custodian when required under state and federal statute.Respondent has the majority of the parenting time under the parenting

above, shall be designated as th

Fl Parents have equal paren

chedule set forthstodian when required under state and federal statute

under t enti scheduleset forth above.

nitials)

of 14

RESTRICTION OF PARENTING TIME

with the child(ren):restrictions or conditions of either party's parenting tin

[+] Not applicable

restriction of parenting time:

COMMUNICATION

1. Communication between the parents regarding the care and well-being of theminor child(ren) shaltake placevia www talkingparents.com _During Petitioner's parenting time, Respondent shall be able to communicateall forms of communication _ at the following times: any reasonable times

3. During Respondent's parenting time, Petitioner shall be able to communicate with the child(ren) viaall forms of communication at the following times: any reasonable times.

with the child(ren) via

ACCESS TO RECORDS OF CHILD(REN):

the child(ren)’s carreports, and schedules unless one of the following two boxes is checked:

Petitioner/Respondent

is expressly denied access to medical, dental, care, school, andextracurricular records, reports and schedules

whois the Petitioner/Respondent

prohibited by a current orde tection from inspthe Domestic Violence Act of 1986 or the Code o

expressly denied acc

obtaining the child(ren)Crimina

to the child(re

EMERGENCY NOTIFICATION: P:

emergencies, roth nt child(ren)- rel

(initials)

of 14

RELOCATION: (as

1. PROCEDURE: Ifaparty who has the majority of parentin;relocate with the child(ren), the relocation party must:

a. Provide written notice of relocation to the other party and file a copy of the notice with theClerkof theCircuit Court.

b. Such written notice shall be provided at least 60 days before relocation unless impracticableor otherwise of shall be provided as soon as possible.

or equal parenting time wishes to

ed by court, in which case noticwritten notice must include, at a minimum

teofrelocation

f relocation, if not permanent

2. NO OBJECTION BY OTHER PARTY: If the non-relocatand

arty does not object tothe relocations the notice provided by the relocating party, the relocating party shall file the notice with

the court. In such case, relocation will be allowed without any further court action. Parties willmodify the parenting planorallocation by agreement to accommodate the relocation and submitsuch plan to the court for approval

WITH OBJECTION BY THE OTHER PARTY: If the non-reloc:relocatio cats

allocation judgment, the

g party objects to thery, or the parties cannot agree

cation must file a

or fails to sign the notice provided by the reting planmodification of the pare y seek;

petition seek

4. DISPUTE RESOLUTION AFTER RELOCATION: AnyOFCOOK COUNTY

OTHER PROVISION1. Neither parent shall di sparage the other parent in front of the child(ren) or on social media.

e 13 of 14

Please re-read this document carefully and make sure that it accurately reflects your entireand that it includes all the issues you wished to address.

greement

Please initial the bottom of every page of this document, including the Addendum. Your initials indicatethat you have read, understood, and agreed with each page that has been initialed. Once you have re-

ad this document carefully and believe that it is accurate, please sign onthe signature lines below.Your signature indicates that you agree with all the terms of this Parenting Plan and that youabide with all terms of this Parenting Plan.

ntendto

Atiomey’s signature, if applicable Date Atiomey's ature, if applicable Date

initials)

IL DEFI

3.

140f 14

ADDENDUM

TIONS 750 TLCS 5/600

PARENTING TIME means the time during which a parent is responsible for exercising non-significant decision-making responsibilities and care-taking responsibilities for the child(ren)(see below). The parent caring for the child(ren) may also direct, arrange, and supervise thirdparties who may perform such care-taking duties for the child(ren). During his or her parentitime, the parent caring for the child(ren) shall have the sole responsibility for making routinedecisions with respect to the child(ren) and for emergency decisions affecting the child(ren)’shealth and safety at the time.

CARE-TAKING RESPONSIBILITIE:«Feeding the child(ren), managing bed-time and wake-up, caring for the child(ren) when

the child(ren) is sick or injured, attending to thechild(ren)’s hygiene needs, playing withthe child(ren), making sure child(ren) attends extra-curricular activiics, protecting thechild(ren)’s physical and providing transportation for the child(ren).

«Directing the child(ren)'s developmental needs, including, motor and language skills,toilet traini

«Providing discipline, assigning chores,his or her behavior

«Ensuring child(ren) attends school and any other special services, communicating withteachers and counselors and supervising homework

«Helping the child(ren) develop and maintain appropriate relationships with family andfriend

include, but are not limited to:

safet

self-confidence and maturationd attending to the child(ren)’s needto control

«Ensuring the child(ren) attends medical appointments, medical follow-ups, and providingany necessary medical carein the home.

«Providing moral and ethical guidance for the child(ren)* Armanging alternative care for the child(ren) by a third party, including investigating the

alternatives, communicating with providers and supervising such care.

RELOCATION constitutes a substantial change in circumstances and is defined as:«A change of residence from the child(ren)’s current primary residence in the county of

Cook, DuPage, Kanc, Lake, McHenry or Will to a new residence within this State that ismore than 25 miles from the child(ren)’s current residence, as measured by an intemetmappin

o Acha s current primary residence located in a countynot listed in paragraph (1) to a new residence within this State that is more than 50 milesaway from the child(ren)’ current primary residence, as measured by an intemet

of residence from the child(

mapping service; or* A change of residencefrom the child(ren)’s current primary residence to a residence

outside the borders of this State that is more than 25 miles from the current primaryresidence, as measuredby an internet mapping service.

STATE OF ILLINOIS))

COUNTYOF COOK )


IN RE THE MARRIAGE OF: )) Divorce Tout nang5

Tn commenPETITIONER, )

)

AND )D

RESPONDENT. )

)

JUDGMENT OF DISSOLUTION O

This cause coming on to be heard on the Petition

by the Petitioner, and it appearing tothe Court that the Respondent,

, was served notice of the pendency of this suit by proper service of

Summons and has filed an appearance and/or answer to the Petition and the Court having

heard testimony taken underoath in open court in support of said Petition; the parties

having entered into an oral agreement and the Court being fully advised in the premises,

findsas follows:

1. That this Court has jurisdiction of the parties to, and the subject matter of, this

cause,

That the Petitioner was domiciled in the State of Illinois at the commencement of

this action and has been an actual resident of this State for a period in excess of


3. That the parties were lawfully joined in Marriage on the day of

, and the Marriage was registered in the County of Cook,State of

Ilinois.

4. That two (2) children were born asa result of the Marriage, no children were

adopted and the Wife is not now pregnant. The names and ages of thechildren are

as follows: + age and ge

a. That Petitioner and nor Respondent has a legal interest in real estate

' and they havecommonly known asagreedto the following

i. That the Petitioner and Respondent shall share equal shares in

possessing thereal estate commonly known as

Chicago, TT through tenancy in common.

That the Petitioner shall execute and record the necessary tenancy inii.

common deed within thirty (30) days fromentry of this judgment.

6. That the Petitioner by competent evidence has met the groundsof irreconcilable

differences.

agreement is set forth as the Court's7. That the Parties’ Court approved and writte

findings andorders hercin.

THEREFORE, BY VIRTUE OF THE STATUTES OF THE STATE OF ILLINOIS AND

ON MOTION OF THE PETITIONER, I'T IS HEREBY ORDERED:

A. That the bonds of matrimony herctofore existing between Petitioner,

Land Respondent, be dissolved as to both Parties

B. Except as otherwise stated herein, each party is awarded those items of personal

property that are now in their possession as their property without claim of the

other party

C. Except as otherwise stated herein, eachparty is liable for the debt incurred and/or

entitled in their own names and holdthe other party harmless of all liability

associated with said debt.

ded any interest they may haveD. Except as otherwise stated herein, each party is aw

in any pension or retirement plan registered in their own name.

a. The real estate commonly known asshall be awarded inequal shares through tenancy in common to thePetitioner and Respondent

b. Ti at the Petitioner shall execute and record the necessary tenancy in

common deed within thirty (30) days fromentry of this judgment

i. Maintenance is barredas to both parties; or

G. That post-high school educational expenses are reserved and shall

be determined pursuant to 750 LCS 5/513.

IL. That this court expressly retains jurisdiction of this cause for the purpose of

enforcing all the terms of this Judgment of Dissolution of Marriage.

ENTER:

Judge

NAM]

ADDRESS

CITY, STATE, ZIP_ Chicago, lilinois

ORNEY NO. (Sel

STATE OF ILLINOI

COUNTY OF COOK

Y, ILLINOISNS DIVISION

IN RE THE MARRL

)

PETITIONER, ))

AND ) CASE NO.

) Cal.RESPONDENT. )

)

JUDGMENT OF DISSOLUTION OF MARRIAGE

This cause coming on to be heard on the Petition for Dissolution of Marriage filed

by the Petitioner, and it appearing to the Court that the

Respondent, , was served notice of the pendency of this s

proper service of Summons and has filed an appearance and/or answer to the Petition and

the Court having heard testimony taken under oath in open court in support of said

Petition; the parties having entered into an agreement and the Court being fully advised in

the premises, findsas follows:

1. That this Court has jurisdiction of the parties to, and the subject matter of, this

cause.

That the Petitioner was domiciled in the State of Tllinois at the commencement ofthis action and has been an actual resident of this State for a period in excess of


3. That the parties were lawfully joined in Marriage on the | day of of the

year of

4. That the Marriage was registered in the County of Cook , State of Tllinois.

That three (3) children were born to the Parties, no children were adopted and the

Wife is not now pregnant. The names and ages of the children are as follows:

on 09/13/1996, born on 03/21/2007

and born on 03/21/2007.

a. That the Petitioner and Respondent hasa legal interest in the real estate

commonly known as Chicago, Illinois 60620

and they have agreed to the following:

i. That Petitioner shall be awarded the real estate commonly known as

Chicago, Minois 60620

ii. That the Respondent shall execute and deliver a Quit Claim Deed

within thirty (30) days from the entry of this judgment to Petitioner

releasing his rights and interest to said property to her.

That the Petitioner by competent evidence has met the grounds of irreconcilable

differences.

8. That the Parties’ Court approvedwritten agreement is reflectedas the Court's

findings andorders herein

THEREFORE, BY VIRTUE OF THE STATUTES OF THE STATE OF ILLINOIS AND

ON MOTION OF THE PETITIONER, ITIS HEREBY ORDERED:

A.

D.

G

That the bondsof matrimony heretofore existing between Petitioner, |

MORDICAN,and Respondent, , be dissolved as to both

Parties.

The Parental Allocation Responsibility Judgment and Parenting Plan are

incorporated and made part of the judgment herein as Exhibit A and shall be

reflected as the termsof this judgment as though said terms were fullyset forth

herein.

+ Child support shall be paidby the Respondent , the supporting parent, in the

amount of § 721.00 , per month pursuant to the agreement of the parties as

reflected in the court order of May 31.2018 in this matter.

That both parents shall obtain and maintain a policy of health insurance and

dental/vision covering the minor children until their emancipation

The issues of life insurance andpost-high school educational expenses are reserved

and shall be determined pursuant to 750 TLCS 5/513. That the issues of educational

and extracurrular activities expenses for the minor children are reserved.

d outside the Stateof Illinois reg g a custodialForpurposes of laws with

parent be designated, Petitioner shall be considered the custodial parent.

Except as otherwise stated herein, each party is awarded those items of personal

property that are nowin their possession as their property without claimofthe

other party

H. Except as otherwise stated herein, each partyis liable for the debt incurred and/or

entitled in their own names and hold the other party harmless of all liability

associated with saiddebt.I Excep otherwise stated herein, each party is awarded any interest they may have

in any pensionor retirement plan registered in their own name.

I.

a. The real estate commonly known as Chicago, Tlinois

60620 shall be awarded to Petitioner.

b. That thereal estate commonly known as Chicago,

Illinois 60620 shall be released and tendered to Petitioner by Respondent

executing and releasing his rights to said property to her within thirty days

of entry of this judgment.

K

i. Maintenance is barred as to oth parties

I. That the Wife be granted leave to resume use of her former name, CRAWFORD

M. That this court expressly retains jurisdiction of this cause for the purpose of

enforcing all the terms of this Judgment of Dissolutionof Marriage.

ENTER

Tudge

Name:

Attorney Code No.: 99500

Address:

City: Chicago, Illinois

Telephone Number:

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