Form Ccfc189-11/09 - Paternity Judgment Form - St.louis County, Missouri Page 3
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313.
The Bureau of Vital Records shall change the name on the birth record(s) of the minor
child(ren) as follows:
_________________________________________________________________________________________
_________________________________________________________________________________________
14.
Other orders are as per the attached Exhibit Number___________, which is incorporated by
reference as if fully set forth herein.
_________________________________________________________________________________________
Court Costs
15.
Court costs are to be paid from the court cost deposit(s) previously posted.
Court costs are waived.
Waiver of Right to Rehearing
(If case is heard by a Commissioner pursuant to RSMo. §487.010 et. seq.)
We, the undersigned parties, do hereby acknowledge receipt of the findings and recommendations of
the commissioner, and waive the right to file a motion for rehearing in this case.
(If heard by a Family Court Judge)
(If heard by a Family Court Commissioner)
Findings and Recommendations of Commissioner:
__________________________
___________
__________________________
___________
Judge
Date
Commissioner
Date
Approved and Adopted as Judgment of the Court:
__________________________
___________
Judge
Date
A certified copy of this judgment is to be mailed to the following person(s):
(Check all applicable boxes)
Plaintiff’s Attorney
Defendant’s Attorney
Guardian ad Litem
____________________________
____________________________
____________________________
(Signature of Attorney)
(Signature of Attorney)
(Signature of Guardian ad Litem)
____________________________
____________________________
____________________________
(Street)
(Street)
(Street)
____________
______ ______
____________
______ ______
____________
______ ______
(City)
(State) (Zip)
(City)
(State) (Zip)
(City)
(State) (Zip)
_________________________
_________________________
_________________________
(Telephone Number)
(Telephone Number)
(Telephone Number)
Plaintiff
Defendant
Third Party
____________________________
____________________________
____________________________
(Signature of Plaintiff)
(Signature of Defendant)
(Signature of Third Party)
____________________________
____________________________
____________________________
(Street)
(Street)
(Street)
____________
______ ______
____________
______ ______
____________
______ ______
(City)
(State) (Zip)
(City)
(State) (Zip)
(City)
(State) (Zip)
_________________________
_________________________
_________________________
(Telephone Number)
(Telephone Number)
(Telephone Number)
Paternity Judgment – Page 3 of 3
Form CCFC189-11/09
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