Fillable Form Vr 180 - Application For Search Of Birth Record Files printable pdf download

State of Illinois

Illinois Department of Public Health

ELIGIBILTY TO OBTAIN AN ILLINOIS BIRTH RECORD

Before a request for a copy of a birth record can be considered you must specify your eligibility to obtain it.

ILCS410/535/25(4) states that copies of birth records may only be issued upon:

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The order of a court of competent jurisdiction

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The specific written request for a certification or certified copy by the person, if of legal age (18 or older), or by a

parent or other legal representative* of the person to whom the record of birth relates; or

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The specific written request for a certification or certified copy by a department of the state, a municipal corporation,

or the federal government

*77 Illinois AdmCode 500.10 refers to “Legal representative” as

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An attorney acting on behalf of a person(s) named on a birth certificate;

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An agent authorized by power of attorney;

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A court-appointed personal representative;

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An agent with written, notarized authorization from a person(s) named on a birth certificate for the purpose of obtaining a

certified copy or certification for that person; or

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Any other agent, approved by the State Registrar as a legal representative of the person to whom the birth certificate relates.

NOTE: Any person who, willfully and knowingly uses or attempts to use, or furnishes to another for use, for any purpose

of deception, any certificate, record, report, certification or certified copy thereof so made, altered, amended, or mutilated; or,

Any person who with the intention to deceive, willfully uses or attempts to use any certification or certified copy of a

record of birth knowing that such certification or certified copy was issued upon a record that is false in whole or in part

or that relates to the birth of another person, is guilty of a Class 4 felony in the state of Illinois (ILCS 410/535/27(f)).

ACCEPTABLE PROOF OF ID

A NON-EXPIRED, GOVERNMENT ISSUED PHOTO ID, such as a driver's license. If you have an extension sticker on

your license, submit a copy of both sides of the license. If you do not have a driver's license, a photo ID Card issued

by the Department of Motor Vehicles can be provided.

If your driver's license or ID Card is expired or not available, you must submit TWO (2) pieces of documentation with

your name on them. In addition to your name, one piece must also have your current address on it to prove your identity.

ONE piece of documentation can be a bill or other USPS mail; the SECOND must be one of the items listed below:

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Medical/car insurance card

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Bank statement

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Credit card statement

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Public assistance card

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Paycheck stub with imprinted information

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Active duty military ID w/ issued and expiration dates

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Voter’s registration card

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EBT Link Card (Illinois Electronic Benefit Transfer)

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Car registration paperwork

SOCIAL SECURITY CARDS ARE NOT ACCEPTABLE

Matrícula Consular card issued after October 2006 is acceptable on its own. However, if issued prior to

October 2006, we need ONE additional type of documentation showing current address as noted above. If

you do not have any of the items listed above, please submit a copy of a current utility bill (electricity, cellular

phone, water, etc.) showing your name and current address.

If you are currently incarcerated, you can submit a dated copy of your prison intake/offender summary sheet

containing your photo. If you have been released from prison within the last six months, a copy of the release

papers along with the prison photo ID will be accepted.

If you are writing from a state or federal agency, you can submit a copy of your photo work badge with issued

and expiration dates.

Form Vr 180 - Application For Search Of Birth Record Files

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