Illinois Administrative Code
Title 77 - PUBLIC HEALTH
Part 500 - ILLINOIS VITAL RECORDS CODE
Appendix H - Affidavits
ILLUSTRATION B - Affidavit by Father

Universal Citation: 77 IL Admin Code ยง ILLUSTRATION B
Current through Register Vol. 48, No. 12, March 22, 2024

STATE OF ILLINOIS

DEPARTMENT OF PUBLIC HEALTH

DIVISION OF VITAL RECORDS

SPRINGFIELD 62702-5097

NOTE: A CERTIFIED COPY OF YOUR MARRIAGE RECORD MUST ACCOMPANY THE COMPLETED AFFIDAVITS. AFFIDAVITS MUST BE SIGNED BEFORE A NOTARY PUBLIC OR THEY WILL NOT BE ACCEPTED.

AFFIDAVIT BY FATHER:

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