410 ILCS 535/25.7
In order to seek a waiver of the fee for a copy of a vital record, the person seeking the record must provide the following certification letter:
Certification Letter for Domestic Violence Waiver for Illinois
Vital Records
Full Name of Applicant:...............................
Date of Birth:........................................
I,........................, certify, to the best of my knowledge and belief, that on the date listed below, the above named individual is a victim or child of a victim of domestic violence, as defined by Section 103 of the Illinois Domestic Violence Act of 1986 (750 ILCS 60/103), who is currently fleeing a dangerous living situation. I provide this certification in my capacity as (check one below):
( ) an advocate at a family violence center who assisted the victim;
( ) a licensed medical care or mental health provider;
( ) the director of an emergency shelter or transitional housing; or
( ) the director of a transitional living program.
Signature:................. Date:........................
Title:.......................... Employer:....................
Email:....................... Phone:.......................
Address:.................. City:........................
State:........................ Zip:.........................
410 ILCS 535/25.7