Illinois Adoption Registry Information Exchange Authorization (VR 161.7 / IL482-1017 / IOCI 16-361)
Official state formAdoptionForm VR 161.7 / IL482-1017 / IOCI 16-361Free downloadLast verified November 10, 2026
Notarized authorization that tells the Illinois Department of Public Health which relatives may receive the registrant's name and address, registry application, original birth certificate copy or medical questionnaire. It is filed with the IARMIE registration.
Who can use this form
- A person who completed a Registration Identification with the Illinois Adoption Registry.
- The applicant's signature must be notarized.
What to send with it
- This form with the applicant's signature notarized.
- File it with the IARMIE Application and the other registration forms.
- The form prints the office's former address. The inventory notes the office moved in September 2026 to 110 W Lawrence Ave, Springfield, IL 62704-2610.
Where to send it
- Mail to
- Illinois Department of Public Health Division of Vital Records 925 East Ridgely Ave. Springfield, IL 62702-2737
- State fee
- Not provided
- Typical processing
- Not provided
- Form revision
- rev. 1/16
- Source
- Official government page