Application For Genealogy Record Form

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Kendall County Clerk & Recorder
111 West Fox Street, Rm. 220
Yorkville, Illinois 60560
630 – 553 – 4104
APPLICATION FOR GENEALOGY RECORD
PLEASE BE SURE THAT THE EVENT HAS TAKEN PLACE IN KENDALL COUNTY
Under Illinois State Law (410 ILCS 535 - Vital Records Act), only specific individuals have legal access to birth, death or
marriage certificates. The Kendall County Clerk’s Office will issue certificates only to authorized individuals. To do
otherwise is a violation of Illinois law. VITAL RECORDS ARE NOT CONSIDERED PUBLIC INFORMATION, NOR ARE
THEY SUBJECT TO THE FREEDOM OF INFORMATION ACT.
To obtain a Birth Record ( Records begin in 1877 )
Certificates of persons over age 75 years or older, who are living, will be released to authorized individuals only.
Fee is $5.00 for the first copy and $2.00 for each additional copy
DATE OF REQUEST____________________
NUMBER OF COPIES____________________
DATE OF EVENT___________________________
NAME ON RECORD____________________________________________________________________________
To obtain a Death Record ( Records begin in 1877 )
Certificates 20 years or older
Fee is $7.00 for the first copy and $4.00 for each additional copy
DATE OF REQUEST____________________
NUMBER OF COPIES____________________
DATE OF EVENT___________________________
NAME ON RECORD____________________________________________________________________________
To obtain a Marriage ( Records begin in 1841 )
Certificates 50 years or older
Fee is $5.00 for the first copy and $2.00 for each additional copy
DATE OF REQUEST____________________
NUMBER OF COPIES____________________
DATE OF EVENT___________________________
NAME ON RECORD____________________________________________________________________________
(Please include both names for marriage)
A SEARCH FEE PER DOCUMENT APPLIES IF THE DOCUMENT IS NOT FOUND.
YOU MUST PROVIDE PHOTO IDENTIFICATION TO RECEIVE ANY VITAL RECORD
MAIL-IN REQUESTS MUST PROVIDE PHOTOCOPY OF ID WHEN SUBMITTING APPLICATION
Please Note: This form may be downloaded & used for mail-in orders. It must be accompanied by the proper
documentation and payment in full by check or money order.
APPLICANT INFORMATION
NAME__________________________________________________________________________________
ADDRESS_______________________________________________________________________________
CITY, STATE & ZIP CODE__________________________________________________________________
DAYTIME PHONE NUMBER_____________________REASON FOR REQUEST_______________________
YOUR RELATIONSHIP TO NAME ON RECORD____________________________________________
I affirm, under penalty of perjury, that the representations made on this application are true to the best of my knowledge and
belief.
SIGNATURE___________________________________________________________________________________

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