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Do not use punctuation in this field. (Hospitals: Enter the Illinois Medicaid number assigned to your facility. County Clerks, and Registrars, etc.: Enter the provider number you currently use (i.e., phone number).
(Cannot deliver to Post Office Box)
Indicate name of unit such as Family Birth Center, Health Information Management, County Clerk's Office, etc., after the staff person's name to ensure proper delivery.
Please do not use punctuation in the phone number
Voluntary Acknowledgment of Paternity
Voluntary Acknowledgment of Paternity – Spanish
Illinois Denial of Paternity
Illinois Denial of Paternity - Spanish
Rescission of Illinois Voluntary Acknowledgment of Paternity
Rescission of Illinois Voluntary Acknowledgment of Paternity - Spanish
Two Parents: Give Your Child HOPE Brochure
Two Parents: Give Your Child HOPE – Spanish Brochure
Request for Application for Child Support Services
Paternity Information You Should Know Brochure
Paternity Information You Should Know – Spanish Brochure
Request for a Certified Copy of the Voluntary Acknowledgment of Paternity
Pre-Natal Brochure – Give Your Child the Gift that Will Last a Lifetime
Pre-Natal Brochure – Give Your Child the Gift that Will Last a Lifetime – Spanish
Envelope, Addressed to Division of Child Support Services, Administrative Coordination Unit
Additional Forms Needed, Not Listed Above