Affidavit Of Parentage (Page 2 of 2) in pdf

MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

Vital Records and Health Data Development Section

AFFIDAVIT OF PARENTAGE

Instructions

This form can be used to establish the parentage of a child and may be used to have information on the father of a child added to the

certificate of birth for the child. This affidavit may be completed at the time of the child’s birth or at any other time after the birth.

It is intended for use by couples who were not married at the time the child was conceived nor at the time of birth. In instances where

the mother was married to someone other than the father when the child was conceived or delivered, a court ruling of her husband’s

nonpaternity is necessary in order to first establish that the child is not the husband’s child.

Completion of this affidavit is voluntary. It indicates the parents wish to acknowledge parentage of a child. The form may be used

by parents who were not married when the child was born or when the child was conceived to legally establish their parentage of a

child.

Proper completion of the form is very important. Forms that are not properly completed will not be accepted for filing. Among other

things, the form must be legible, must be typed or printed in ink, must be signed by both parents, and must be properly notarized. At a

minimum, the following items must be provided: the full names of the child, the mother and the father, the date and place of the child’s

birth, the address of each parent and the birth places of each parent.

There is no fee for filing the affidavit with the Central Paternity Registry. Once filed, copies of the affidavit can be obtained by either

parent, by the child or a guardian or legal representative of a parent or the child. Certified copies of the affidavit are available from the

central registry for $26.00 (additional copies are $12.00 each) and can be requested at the time of filing.

Adding a Father to the Birth Certificate

Establishing Paternity at the Hospital – If this affidavit is completed at the time of birth and provided to hospital staff before the

birth certificate is prepared and filed, the birth certificate will be completed to include the father with no need for a separate application

or fee. When completed at the time of birth and used as the basis for recording the father on the original certificate of birth, hospital

staff must forward the original affidavit, along with the original birth certificate, to the local registrar. The local registrar will forward

the affidavit to the Central Paternity Registry for final filing.

Establishing Paternity After Leaving the Hospital – Birth certificates are not automatically changed when an affidavit is filed,

except when completed in the hospital at the time of the birth and before the birth has been registered. Changes to registered birth

records can be requested based upon a properly completed affidavit and an Application to Add a Father on a Michigan Birth Record.

If the affidavit is going to be used to add the father’s name to a Michigan birth record, the affidavit SHOULD NOT BE MAILED TO

THE CENTRAL PATERNITY REGISTRY, but should be mailed along with the correction application to add the father to the address

listed on the application. A birth record can be changed to reflect the father listed on the affidavit if no other man is recorded on the

record as the child’s father. Should a conflict exist, a court determination of paternity may become necessary.

There is a fee for each birth record change, as is noted in the payment section of the correction application. An application to correct a

birth certificate is available from the office of the county clerk, the State Vital Records office recorded message (517) 335-8656, or can

be downloaded from the Michigan Department of Community Health Web site at:

To file the affidavit and request a copy and/or to change the birth record, mail the completed affidavit, the required fee and, for a birth

record change, a completed Application to Add a Father on a Michigan Birth Certificate (form DCH 0848) to:

VITAL RECORDS CHANGES

P.O. Box 30721

Lansing, Michigan 48909

To simply file the affidavit to establish paternity and not request a copy or a change to the birth record, mail to:

Central Paternity Registry

Vital Records & Health Data Development Section

Michigan Department of Community Health

P.O. Box 30691

Lansing, Michigan 48909

Completion of this Form is Voluntary

ALTERATION OF THIS FORM OR THE MAKING OF FALSE STATEMENTS WITH THE

AFFIDAVIT FOR THE PURPOSES OF DECEPTION IS A CRIME.

[MCL 333.2894]

DCH-0682w (6/2006) By authority of Act 305 of 1996

Affidavit Of Parentage Page 2

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