IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT
LAKE COUNTY, ILLINOIS
IN RE THE
MARRIAGE
PARENTAGE
)
SUPPORT
ALLOCATION OF
)
CIVIL UNION
PARENTAL RESPONSIBILITY )
)
) Case No. ________________________
____________________________________________________
Petitioner
)
vs.
) Previous or current Ops involving either party:
) OP Case No. ____________ County: _____________
________________________________________________
) OP Case No: ____________ County: ____________
Respondent
)
ALLOCATION OF PARENTAL RESPONSIBILITIES
EVALUATION REFERRAL ORDER
On motion of:
Petitioner
Respondent
Attorney for Minor Child
Child Rep
Court
It is hereby ordered that this matter is referred to:
Professional/Evaluator/Investigator::
Name ________________________________________________________________________________________
Address _______________________________________________________________________________________
Telephone ____________________________________
Fax ______________________________________
Pursuant to:
750 ILCS 5/604.10(b), to provide the court with professional advice on issues relating to the best interests and
wishes of the child(ren) who is/are the subject of allocation of parental responsibility proceedings.
750 ILCS 5/604.10(c), for an evaluation concerning the best interests of the child(ren) as it relates to allocation of
parental responsibility. The time and place of the evaluation shall be pursuant to court order if agreement by the
parties cannot be reached.
750 ILCS 5/604.10(d), to conduct an investigation concerning the allocation of parental responsibility for a child
who is the subject of the allocation of parental responsibility proceedings.
Party A Name: __________________________________________________
Telephone: (
)
Address: _________________________________________________________________________________
(Street/City/State/ZIP)
Attorney for Party: _________________________________________
Telephone: (
)
Address: _________________________________________________________________________________
(Street/City/State/ZIP)
Party B Name: __________________________________________________
Telephone: (
)
Address: _________________________________________________________________________________
(Street/City/State/ZIP)
Attorney for Party: _________________________________________
Telephone: (
)
Address: _________________________________________________________________________________
(Street/City/State/ZIP)
GAL/AFC/CR Name: ______________________________________________
Telephone: (
)
Address: _________________________________________________________________________________
(Street/City/State/ZIP)
Scope of appointment:
Allocation of parental responsibility -
Original
Modification
Parenting time -
Original
Modification
Abuse
Relocation
Other conditions of appointment ________________________________
171 – 247 (Rev 12/15)
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