Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 500 - ILLINOIS VITAL RECORDS CODE › Appendix B - Delayed irth Records › ILLUSTRATION A - Instructions for Filing a Delayed Record of Birth for a Child Age One to Seven Years

Current through Register Vol. 48, No. 28, July 12, 2024
Division of Vital Records
605 West Jefferson Street
Springfield, Illinois 62702
Telephone (217)782-6553
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
				  1111/2 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.
Page 2
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.
SUGGESTED DOCUMENTS
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.