State of illinois affidavit and certificate of correction request 2026

1. Click ‘Get Form’ to open the State of Illinois Affidavit and Certificate of Correction Request in our editor.
2. Begin by clearly printing or typing your current legal name in the designated field. This should reflect your name as it appears on the birth record.
3. Indicate your relationship to the individual named on the record, such as mother, father, or self, in the appropriate section.
4. Select the type of record you are seeking to correct by placing a check mark next to 'Birth', 'Stillbirth/Fetal Death', or 'Death'.
5. Fill out the particulars of the record in question, including the name currently on record, place of birth or death, and date of birth or death.
6. Specify what information needs correction by detailing how it currently reads and how it should read in the provided fields.
7. Complete your current address and sign the affidavit. Ensure that you do this in front of a notary public.
8. Gather all required documents, including a government-issued photo ID and payment, then return them to the Illinois Department of Public Health.

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