TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER e: VITAL RECORDS
PART 500 ILLINOIS VITAL RECORDS CODE
SECTION 500.APPENDIX B DELAYED BIRTH RECORDS
Section 500.APPENDIX B Delayed Birth Records
Section 500.ILLUSTRATION A Instructions for Filing a Delayed Record of Birth for a Child Age One to Seven Years
Division of Vital Records
605 West Jefferson Street
Springfield, Illinois 62702
INSTRUCTIONS FOR FILING A DELAYED RECORD OF BIRTH
FOR A CHILD AGE ONE TO SEVEN YEARS
Under the provisions of Paragraph 73-14 of the Vital Records
(Illinois Revised Statutes 1989, Chapter 111½ Paragraphs, 73-1 - 73-29)
WHOSE BIRTH MAY BE RECORDED? Any living child, who was born in Illinois more than one year but less than seven years ago, whose birth was not recorded before. The birth facts must be proved by documents. See other side of this page. (to Record the birth of anyone over age seven, write for instructions.)
WHO MAY APPLY? The child's parent, legal guardian, or other legal representative.
HOW TO FILL IN THE DELAYED RECORD OF BIRTH (Form VR 141A). Enter the correct information at items #1 through #8. The affidavit portion (item #9) requires the notarized, personal pen-and-ink signature of the parent, legal guardian, or other legal representative, and address. (A married woman should sign her given names and legal surname.) The notary public must complete his certification, and affix his signature and seal.
(Illegitimate births: If the mother was not married to the father of the child either at the time of conception or birth, the name of the father shall not be entered on the certificate of birth without the written consent of the mother and the person to be named as the father; unless a determination of paternity has been made by a court of competent jurisdiction, in which case a certified copy of the court order shall be submitted. The written consent can be furnished by separate statements by the mother and father, or by having both of them sign at item #9 of the Delayed Record.)
IMPORTANT! Remember, the birth record is an important permanent legal paper; it must be clearly readable. Signatures must be written (not printed) in a permanent black ink. All other entries, should be typewritten in black ink or hand-printed clearly with black ink. Strike-overs and erasures should be avoided.
Illinois law requires that each request to file a Delayed Record of Birth shall be accompanied by a fee of $10.00. This fee entitles the applicant to one certified copy of the Delayed Record of Birth when accepted for filing. Each additional copy is $2.00 when ordered at the same time. Make check or money order payable to the Illinois Department of Public Health.
INSTRUCTIONS FOR FILING A DELAYED RECORD OF BIRTH
FOR A CHILD AGE ONE TO SEVEN YEARS--(Cont'd)
SELECTING DOCUMENTS TO PROVE THE BIRTH FACTS
• The birth facts below, as entered on the Delayed Record of Birth, must be proven at least once:
Place of birth. Father's full name.
Date of birth. Mother's full maiden name.
• It may take more than one document to prove the birth facts.
• Documents created at or nearest the time of birth make the best proof, and the best birth record.
• There must be no unexplained alterations on the documents submitted as proof.
• Either the original document, a certified photograph or copy of the original document, or a certified statement of the facts about the birth that appear in the document, may be used.
• The document must show when and with what agency or official the information was originally recorded, including any particular identifying file number, and the complete address of such agency or official.
HOSPITAL'S RECORD OF THE DELIVERY (if child was born in a hospital) – obtain from the hospital.
ATTENDING PHYSICIAN'S OR MIDWIFE'S RECORD OF THE DELIVERY – obtain from the physician, midwife, or present custodian of their records.
BAPTISMAL, CRADLE ROLL, OR OTHER CHURCH RECORD – obtain from the pastor or other person who now has the church records.
BIRTH ANNOUNCEMENT – submit one which was sent to a relative or friend.
COPY OF LIFE INSURANCE APPLICATION – obtain from the insurance company.
FAMILY BIBLE RECORD – submit only if entry is dated and was made at or near the time of the birth. Name and address of the present custodian of the Bible must be furnished.
HOSPITAL ADMISSION RECORD (if the child was ever a patient in a hospital since birth) – obtain from the hospital.
SCHOOL ENROLLMENT OR SCHOOL CENSUS RECORD – obtain from the county superintendent of schools or the city board of education where the child entered school. (If the child first entered school in the City of Chicago, write the Chicago Board of Education, 228 North LaSalle Street, Chicago, Illinois 60601.)
FEDERAL CENSUS REPORT (if census was taken since the child's birth) – available from the U.S. Department of Commerce, Bureau of the Census, Pittsburgh, Kansas 66762. Application blanks may be obtained from the county clerk or the Illinois Department of Public Health.
(Source: Added at 15 Ill. Reg. 11706, effective August 1, 1991)