WebObtaining a New Birth Certificate. To change an Illinois birth record by court order to your or your minor’s new name, send the following to: Illinois Department of Public Health. Division of Vital Records. 925 E. Ridgely Ave. Springfield, IL 62702-2737. Email: [email protected]. WebThis form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Circuit Courts. NCM-CI 2004.1 Page 1 of 2 (02/17) STATE OF ILLINOIS , REQUEST FOR NAME CHANGE - CHILD INFORMATION . For Court Use Only. CIRCUIT COURT COUNTY Instructions Enter above the county name where you will file this case.
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