IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
COUNTY DEPARTMENT-DOMESTIC RELATIONS DIVISION
In RE the Marriage of: )
)
)
Petitioner )
)
and ) No.
)
)
Respondent )
CUSTODY INTERROGATORIES FOR PRO SE LITIGANT
To:
These Custody Interrogatories are served pursuant to Illinois Supreme
Court Rule 213. YOU ARE REQUIRED TO COMPLETE THEM WITHIN 28 DAYS OF
RECEIVING THEM. Once you have answered the Interrogatories out
completely,
YOU ARE REQUIRED TO:
1) File a copy of the completed Custody Interrogatories at the Clerk’s
Office in room 802 at the Richard J. Daley Center at Randolph and
Washington, AND
2) Send a copy to the attorney for the other parent as soon as they are
filed.
Note: Please answer these questions completely. If you do not know an answer please put “don’t know”,
If you do not understand a question put “Don’t understand”, or
if a question is "not applicable" to your situation, please put N/A.
1. Name _____________________________________________________(______________)
(First) (Middle Initial) (Last Name) (Maiden Name)
2. Date of Birth _________________Place of Birth __________________________________
(Month-Day-Year) (City-State / City-Country)
3. Home Address ____________________________________________________________
(Number/Street) (Apt./Floor #) (City) (Zip Code)
4. Employer _________________________________________________________________
(Name) (Address)
5. Telephones, pagers, faxes, e-mail, etc. (Please include "Area Codes"):
_________________________________________________________________________
(Home) (Job) (Pager) (Other)
6. Social Security No. ______________________ Public Aid No. _______________________
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7. Marital Status: Single ________ Married ________ Divorced ________ Separated _______
8. Please fill out whatever applies:
a) Date and Place of Marriage ________________________________________________
b) Date and Place of Divorce _________________________________________________
c) Date of Separation _______________________________________________________
d) If never married,
Date and Place paternity was established ____________________________________
9. Information about the child(ren). If more than one, please start with the oldest.
i. _______________________________________________________________________
(Complete Name) (Date Birth) (Place Birth) (SS#)
ii. _______________________________________________________________________
(Complete Name) (Date Birth) (Place Birth) (SS#)
iii. _______________________________________________________________________
(Complete Name) (Date Birth) (Place Birth) (SS#)
iv. _______________________________________________________________________
(Complete Name) (Date Birth) (Place Birth) (SS#)
10. Please explain why you believe it is in the best interest of the child(ren) for you to have
custody.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
11. Please explain why you believe it is not in the best interest of the child(ren) for the other
parent to have custody.
____________________________________________________________________________
____________________________________________________________________________
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____________________________________________________________________________
____________________________________________________________________________
12. Please describe the exact circumstances and times of any past incidents known to you
when the other parent directed any kind of physical or emotional abuse at the child(ren).
Also describe any and all reports of those incidents that you made to governmental officials
and/or the police at or near the time the incidents happened.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
13. If you have made allegations to the police, other government officials or in court documents,
that the other parent has engaged in improper conduct (sexual, physical, kidnapping acts or
threats) with the child(ren) or poses a risk of any kind to the children, please describe in
detail any evidence that you can provide in support of the allegations that you made.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
14. When you, the other parent and the child(ren) were living together, which parent was the
primary caretaker of the child(ren)? Please identify in detail the evidence that you can
supply to support that statement. If you believe that you and the other parent shared equally
in primary caretaker responsibilities, please explain.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
15. If you currently are NOT the primary caretaker, please explain why the Judge should not
award custody to the other parent.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
16. If you currently are NOT the primary caretaker, please explain why you believe that you are
capable of becoming the child(ren)'s primary caretaker and what steps you are planning to
take in order to take on these duties.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
CERTIFICATION
I hereby certify, under penalties of perjury, that the foregoing statements are true based upon
my own information and belief.
DATE ________________ ______________________________________________
SIGNATURE
______________________________________________
PLEASE PRINT YOUR NAME
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Sworn and subscribed to before me this _______ day of _____________________ of 20___.
___________________________
NOTARY PUBLIC
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