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Request For a Non-Certified Copy of an Original Birth Certificate

The following form has to be executed by the person who requested it. This form is used to request a non-certified copy of an original birth certificate that falls under the State of Illinois Adoption Registry And Medical Information Exchange. Registrants are allowed to authorize of prohibit releasing identifying information that is listed on the original birth certificate. The people referred to as “recipients” are those involved in the surrender or adoptionĀ of another person.

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