Form Ldss-4418 - Notice Regarding Your Legal Rights And The Consequences Of Signing An Acknowledgment Of Paternity Page 4

ADVERTISEMENT

LDSS-4418
NYC (Rev. 10/02)
MAIL pages 3 and 4 of this form to:
New York City Department of Health & Mental Hygiene
Office of Vital Records
Attention: Corrections Unit, Room 144
125 Worth Street, Box 4
New York, NY 10013
If you want to obtain a new birth certificate, either:
Enclose a check or money order for $15.00, or
Return a newborn birth certificate (Form no. VR-133); it may not be a
photocopy, and it must have been issued within the last year.
FATHER
Mailing address of Father must be printed here.
Name _______________________________________________
A copy of this Acknowledgment will be mailed to him
Address _____________________________ Apt. ____________
when it is filed with the New York City Department of
City _____________________ State _______ Zip ___________
Health & Mental Hygiene.
(Fold Here)
(Fold Here)
Mother’s telephone number(s)
Daytime __________________
Evening __________________
MOTHER
Mailing address of Mother must be printed here.
Name:________________________________________________
A copy of this Acknowledgment will be mailed to her
Address _______________________________ Apt. ___________
when it is filed with the New York City Department of
City:_______________________ State: __________Zip_________
Health & Mental Hygiene.
Page 4 of 4

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Dte 111 - Notice To Refi Le Application For The Valuation Of Land In Accordance With Its Current Agricultural Use Form Dte 111 - Notice To Refi Le Application For The Valuation Of Land In Accordance With Its Current Agricultural Use Financial
Form Fmla-hr2a - Notice Of Eligibility And Rights And Responsibilities - State Of Connecticut Human Resources Form Fmla-hr2a - Notice Of Eligibility And Rights And Responsibilities - State Of Connecticut Human Resources Business
Form Rev-554 Eo - Disclosure Statement: Taxpayers' Rights And Obligations Of The Department Of Revenue Form Rev-554 Eo - Disclosure Statement: Taxpayers' Rights And Obligations Of The Department Of Revenue Legal
Form Dhcs 7102 - Notice Regarding Standards For Medi-cal Eligibility And Recovery Form Dhcs 7102 - Notice Regarding Standards For Medi-cal Eligibility And Recovery Legal
Form Ad-1048 - Certification Regarding Debarment, Suspension, Ineligibility And Voluntary Exclusion - Lower Tier Covered Transactions Form Ad-1048 - Certification Regarding Debarment, Suspension, Ineligibility And Voluntary Exclusion - Lower Tier Covered Transactions Legal
Notice To Plaintiff District Court For The State Of Alaska Notice To Plaintiff District Court For The State Of Alaska Legal
Form Gs-1078 - Attestation Regarding Personnel Used In Contract Performance - Department Of General Services Form Gs-1078 - Attestation Regarding Personnel Used In Contract Performance - Department Of General Services Legal
Form 5213 - Election To Postpone Determination As To Whether The Presumption Applies That An Activity Is Engaged In For Profit Form 5213 - Election To Postpone Determination As To Whether The Presumption Applies That An Activity Is Engaged In For Profit Financial
Form 5213 - Election To Postpone Determination As To Whether The Presumption Applies That An Activity Is Engaged In For Profit Form 5213 - Election To Postpone Determination As To Whether The Presumption Applies That An Activity Is Engaged In For Profit Financial
Form 5213 - Election To Postpone Determination As To Whether The Presumption Applies That An Activity Is Engaged In For Profit Form 5213 - Election To Postpone Determination As To Whether The Presumption Applies That An Activity Is Engaged In For Profit Financial

Related Categories

Parent category: Legal
Download
Go
Page of 4