Affidavit Acknowledging Paternity
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4MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES
BUREAU OF VITAL RECORDS
AFFIDAVIT ACKNOWLEDGING PATERNITY
WRITTEN NOTICE OF ALTERNATIVES, RIGHTS AND RESPONSIBILITIES
The Affidavit Acknowledging Paternity is a legal document. Please read the information provided below
before completing an Affidavit. Following are the alternatives to completing the Affidavit and your legal
rights and responsibilities. Before you complete an Affidavit Acknowledging Paternity, you must receive
oral (spoken) notice of the below information. If you are completing the Affidavit at the hospital when
your child is born, you may receive oral notice from hospital staff. If you are completing the affidavit after
the birth certificate has been filed, you may receive oral notice from the agency that gave you the form.
You may also receive oral notice by calling (toll free) 1-888-677-2083.
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When both parents properly complete and sign an Affidavit Acknowledging Paternity, the manʼs
name is added to the childʼs birth certificate, and the man becomes the legal father of the child.
Properly completed affidavits have the same effect as a court order establishing paternity and can
be used as a basis for entering a child support order.
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If either of you is not sure that this man is the biological (natural) father of this child, you should not
sign an Affidavit Acknowledging Paternity. You should have a genetic test. If the test shows at least
a 98 percent probability that the man is the father, then Missouri law says he is the presumed father.
A genetic test can be provided by the Family Support Division (FSD). Either of you may apply for this
service by calling FSD at 1-800-859-7999. If the genetic test shows that the man is the childʼs
biological father, you may then sign an Affidavit Acknowledging Paternity.
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If either of you change your mind about acknowledging paternity after you have signed the Affidavit,
you may sign a rescission form and file it with the Missouri Department of Health and Senior
Services, Bureau of Vital Records (BVR) within the earlier of: 60 days from the date of the last
signature on the Affidavits; or the date of a proceeding to establish child support for the child on the
Affidavits. Contact BVR at (573) 751-6378 if you need a rescission form. When the rescission is filed,
the man will no longer be the legal father; however, his name will stay on the birth certificate unless
a court order tells BVR to remove his name.
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If it is more than 60 days after both of you sign the Affidavits or after the date of a child support
proceeding, and you decide you want to prove this man is not the father, you must go to court. You
must prove there was fraud, duress, or material mistake of fact when you signed the Affidavit.
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This child may have the right to receive benefits as the legal child of the man who signs an Affidavit
Acknowledging Paternity. These benefits may include child support, medical insurance, inheritance
rights, Social Security and Veteranʼs benefits.
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Acknowledging paternity does not automatically give the father visitation or custody rights. Please
seek legal advice regarding custody and visitation rights, or any other related legal matters.
Persons who knowingly supply false information on the Affidavit Acknowledging Paternity shall be guilty
of a class D felony. Penalties under the criminal code range from imprisonment of 1-10 years and/or up
to $5,000 in fines.
MO 580-0651 (1-10)
VS 465 (1-10)
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