STATE OF ILLINOIS ss. COUNTY OF COOK REVOCATION OF APPOINTMENT OF SHORT-TERM GUARDIAN 1. I,, currently residing at----------------- -----------, am a parent ofthe following child: -------------- born 2. On---------" I appointed the following person as the short-term guardian for my child: (----------- (----------------------- --------------------------------- The appointment was to terminate on ----------- 3. I hereby revoke the appointment of as short-term guardian of, and this revocation shall be effective immediately. 4. This revocation of short-term guardian appointment is made this day of, 20. Signed: Witnesses: I saw the parent sign this instrument, and then I signed this instrument as a witness in the presence of the parent. I have not been appointed to act as the short-term guardian for the parent's child. Witness I Witness 2:
STATE OF ILLINOIS ss. COUNTY OF COOK APPOINTMENT OF SHORT-TERM GUARDIAN 1.!,,currently residing at, am a parent of the following child: born 2. I hereby appoint the following person as the short-term guardian for my child: (------------ (--------------------- 3. This appointment becomes effective immediately upon the date that this form is signed and dated below. 4.This appointment shall terminate on-------------------- 5. This appointment is made this day of, 20. Signed: --------------- 6. Witnesses: I saw the parent sign this instrument, then I signed this instrument as a witness in the presence of the parent. I am not appointed in this instrument to act as the short-term guardian for the parent's child. Witness 1: Witness 2: 7. Acceptance of guardian: I accept this appointment as short-term guardian on this day of,, 20. Signed:
STATE OF ILLINOIS COUNTY OF COOK ss. SAMPLE APPOINTMENT OF SHORT-TERM GUARDIAN 1. I, Janie Doe, currently residing at..:..:in..:..:s::..:e:::..r...:.f...:a::..:d:..:'ch:::..r-=e::s..::.'s, am a parent of the following child: ;J,._o=h'-'-'n..!!.n 4 y'-'a'-"'-. =D=o=e,, bom,._j-=u"+ly 22 2011 2. I hereby appoint the following person as the short-term guardian for my child: (!..!.M,!,:,a!!..r+-y~D::..::o::..::e~--- ( ---=1:.:1.:..:11=--=-W"-e::O:s"-'t'--A'-=d=a'-'-m-==s"-,.:...;A'-~=p'-'-t.:..._. =-=11=------------ Chicago. IL 60111 3. This appointment becomes effective immediately upon the date that this form is signed and dated below. 4. This appointment shall terminate on,j:...:u::..:.ly~--=2:..;:3'""",-=2:.;:0:.;:1;.::2'--------- 5. This appointment is made this 23rd day of,j-=u!.!..ily,,, 20 12 Signed: -----...JI-.!<.~!..!..[1\,_,te""'--'-R.o"""'""e'------ 6. Witnesses: I saw the parent sign this instrument, then I signed this instrument as a witness in the presence of the parent. I am not appointed in this instrument to act as the short-term guardian for the parent's child. Witness 1 ccwol Poe -~~~~------- Witness 2: --'L""'Ci"""IA."'"r"'"Ci.!...CM'-"o""e'--------- 4444 N State St. 2222 N. State Street Chicago. IL 60666 Chicago, IL 60666 (Notary seal here is helpful if one witness can notarize but NOT required 7. Acceptance of guardian: I accept this appointment as short-term guardian on this 24th day of July,20 11 Signed:,.Mwuj==;;<:-=:J=o.e-=-------
STATE OF ILLINOIS COUNTY OF COOK IN THE CIRCUIT COURT OF THE 1st JUDICIAL CIRCUIT COOK COUNTY, ILLINOIS John Smith, v. Jane Smith, Petitioner, Case No: 15 D 9999999 Respondent. WRIT OF HABEAS CORPUS AD TESTIFICANDUM THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS to ANGELA LOCKE, ACTING WARDEN LOGAN CORRECTIONAL CENTER 1096 1350th Street P.O. Box 1000 Lincoln, IL 62656 WE COMMAND YOU to bring the body of Jane Smith, G91621, to a hearing on April15, 2015 commencing at 12:00 PM in Room 1901 at the Daley Center, located at 50 W. Washington, Chicago, IL, 60601. If her minor child is present Jane Smith's handcuffs shall be removed during the hearing to avoid upsetting her minor child. ENTER:
STATE OF ILLINOIS COUNTY OF COOK IN THE CIRCUIT COURT OF THE 1st JUDICIAL CIRCUIT COOK COUNTY, ILLINOIS John Smith, Petitioner, v. Jane Smith, Case No: 15 D 9999999 Respondent. PETITION FOR WRIT OF HABEAS CORPUS AD TESTIFICANDUM NOW COMES JANE SMITH, the Respondent, in the above-entitled cause, pro se, and states as follows: 1. The Respondent is the mother of the minor child in this action. 2. This matter is a Petition for Custody in which the best interest of the minor must be determined. The testimony of the mother is vital to this honorable Court's determination of the best interest of the minor child. 3. The Respondent is in the custody of the Illinois Department of Corrections and is being held at Logan Correctional Center. In order for her to testify in Court, a Writ of Habeas Corpus must be issued to the Warden at Logan Correctional Center. 4. This Honorable Court has the authority to grant this petition pursuant to 735 ILCS 5/10-135. 5. The Petitioner is unable to pay costs related to the writ. WHEREFORE, Petitioner prays that this Court grant the following relief: A. Enter an Order directed to Angela Locke, Logan Correctional Center, commanding her to have Jane Smith present at the next Court hearing date. B. Order that if the minor child is present, Kimberly Smith's handcuffs shall be removed to avoid upsetting the minor child.
C. Waive any costs to Petitioner related to the writ. Respectfully submitted, Jane Smith K91621 Logan CC PO Box 1000 Lincoln, IL 62656 (217 735-5581 via Counselor Loren Wilson Petitioner
ILLINOIS DEPARTMENT OF CORRECTIONS Permission to Allow Visitation of a Minor Child ------------Correctional Center I, ---.,.----...,.---------affirm that I am the legal guardian of -::-:-::-::-:::-:7-:-:----- Legal Guardian Child's Full who is a child not yet of majority. Said child is years of age, with a date of birth of-------- I hereby give my permission and consent for ---~,---..,-,..-.,..,.--------' ID# Offende~s Child's Full to visit with Offender -------,::-:-::--::--:::-::--:-:--------will be accompanied by-----,..,.---:-=--.,---------' who is of majority Child's Full of Escort and will also be visiting the above named offender. I understand and have explained to ------=--=-::-::--=-::-:-:------that all Child's Full Illinois Department of Corrections Rules governing Offender visits must be complied with and any violations of Department Rules will result in immediate termination of the visit and could result in the restriction of future visits. Please check one (only one box can be checked : 0 I understand this permission document remains in effect for 1 year from the date of the signature below. 0 I only give my permission and consent for ----=-::-::--=-::-:-:-------to visit on the following dates: Child's Full Signature of Legal Guardian: ---------------------------------- Legal Guardian Contact Information: : ~~-----------=--------~.,...--------~~.,...--- Street City State Zip Code Telephone:-------------- Subscribed to and sworn before me this--------- day of---------- Notary Public Distribution: Visitor Master File Visiting File Prmted on Recycled Paper DOC 0330 (eft. 6/2008