The affidavit shall be created by the county clerk, may appear on a combined form with the form under subsection (b), and shall be substantially as follows:
REQUEST FOR NONGENDERED COPY OF A MARRIAGE CERTIFICATE
I,.........., state that I am a named spouse on a marriage license held in this office, that I am still married to the other named spouse on that marriage license as of the date of this request, and hereby request the holder of this record provide me, and only me, with a marriage certificate with any gender-identifying language removed or changed to "spouse". I affirm that this change is for purposes of this certified copy, the change will not be made to permanent records, and a record of this request shall be held by the holder of this marriage record.
Date..........
Signature..........
The affidavit shall be created by the county clerk, may appear on a combined form with the form under subsection (a), and shall be substantially as follows:
REQUEST FOR NONGENDERED COPY OF A MARRIAGE CERTIFICATE
We,..........[Spouse A] and..........[Spouse B], the still-married named persons on a marriage license held in this office as of the date of this request, hereby request the holder of this record to provide a marriage certificate with gender-identifying terms such as "bride" and "groom" changed as follows:
..........[Name of Spouse A] Bride, Groom, or Spouse (select one).
..........[Name of Spouse B] Bride, Groom, or Spouse (select one).
We affirm that this change is for purposes of this certified copy, and the change will not be made to permanent records, unless indicated by selecting Yes or No (select one) and a record of this request shall be held by the holder of this marriage record.
Date..........
Signature of Spouse A..........
Signature of Spouse B..........
750 ILCS 5/222