Get Birth Record Request Form - A3 - Cook County Clerk's Office

Filling out the Birth Record Request Form - A3 is an essential step in obtaining official birth records. This guide provides clear and supportive instructions on completing the form online, ensuring a smooth and efficient process for all users.

Follow the steps to fill out the Birth Record Request Form online.

1. Click the 'Get Form' button to access the Birth Record Request Form. This will allow you to open the document for completion.
2. Begin by selecting your status from the available options: homeless, survivor of domestic abuse, ex-offender, or current detainee/inmate. Please ensure that you select the appropriate category that accurately reflects your situation.
3. Provide the birth record information by filling in the name at birth, date of birth, and place of birth. Ensure accuracy to avoid any delays in processing your request.
4. Fill in the names of the mother and father as they appear on the birth record. If an entry does not apply, leave it blank.
5. In the requestor’s information section, enter your full name, signature, telephone number, and mailing address. If you are not the person requesting the record, indicate your relationship to the child.
6. If applicable, complete the Status Certification section if you are eligible for a free birth certificate due to your status. Ensure that this section is filled out by an authorized agent or agency.
7. Review all entries for accuracy and completeness. Once verified, you can save changes to your document.
8. The final step allows you to download, print, or share the filled-out form based on your preference for submission.

Complete your birth record request online today!