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01. Edit your illinois identity form online
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Send il444 3610 via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out il request with our platform
- Click ‘Get Form’ to open the State Identity Proofing Request Form in the editor.
- Begin by entering your ABE Username, First Name, Last Name, Date of Birth, Phone Number, and Email Address in the designated fields.
- Fill in your Mailing Address. If this address differs from what is on file with the State, indicate whether you want it updated by selecting 'Yes' or 'No'.
- Provide either your Social Security Number or Case/Application Number as required. Ensure that all asterisked (*) fields are completed.
- Answer the questions regarding Medicaid services and representation accurately. If applicable, attach a signed Approved Representative form.
- Review your entries for accuracy and completeness before signing and dating the form at the bottom.
- Attach a copy of acceptable identity proofing documentation as specified in the instructions and submit the form via mail or fax.
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