Illinois Administrative Code
Title 77 - PUBLIC HEALTH
Part 500 - ILLINOIS VITAL RECORDS CODE
Appendix E - Adoption Records
ILLUSTRATION M - Adoptive Parent Registration Identification Form
Universal Citation: 77 IL Admin Code ยง ILLUSTRATION M
Current through Register Vol. 48, No. 12, March 22, 2024
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_______________________________ |
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(signature of adoptive parent) |
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___________________________ |
________________________________ |
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(date) |
(printed or typed name of adoptive parent) |
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Illinois Department of Public Health, Division of Vital Records, 605 W. Jefferson St., Springfield IL 62702-5097 |
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VR 161.4 (rev. 05/2000) |
Printed by Authority of the State of Illinois P.O. # 30M 02/00 |
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