Form 03pa209e - Acknowledgment Of Paternity - Oklahoma Department Of Human Services

Download a blank fillable Form 03pa209e - Acknowledgment Of Paternity - Oklahoma Department Of Human Services in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 03pa209e - Acknowledgment Of Paternity - Oklahoma Department Of Human Services with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

*03PA209E-001*
OKLAHOMA DEPARTMENT OF HUMAN SERVICES
Acknowledgment of Paternity
This legal document establishes paternity under Oklahoma law. Do not
Name of hospital or entity
Facility code number
completing form
sign unless you understand your rights and responsibilities as explained
on the back of this form. Type or print in ink by pressing hard. No
cross outs, correction fluid, or alterations are allowed.
Child's information as it now appears on birth certificate.
Middle
Last
Suffix
Social Security
Child's first name
Number
Date of birth
Sex:
Place of birth, city
County
State
Last name of child should
now be
Male
Female
OK
Middle
Last
Maiden name
Mother's first name
Date of birth
Social Security number
Daytime phone number
Current street address
City
State
Zip code
If yes, husband's name
If yes, husband/former husband must complete Form
Was mother married at
03PA210E, Denial of Paternity, and attach it to this Form
time of conception or
03PA209E.
birth?
Yes
No
Middle
Last
Suffix
Father's first name
Date of birth
Place of birth, state or foreign country
Social Security
Daytime phone number
number
Current street address
City
State
Zip code
Have you taken a genetic test to determine paternity of this child?
Yes
No
If yes, did the test result show that you are the father of this child?
Yes
No
If the genetic test showed you are NOT the biological father, STOP NOW, DO NOT SIGN.
By signing below, I declare under penalty of perjury that I read and understand this
Acknowledgment of Paternity. I declare the information in this Acknowledgment is true and:
1.
I have been given written and oral notice of my legal rights and responsibilities.
2.
I understand this acknowledgment is the equivalent of a judicial adjudication of paternity and that a challenge to
the acknowledgment is permitted only under limited circumstances and is barred after two years.
3.
By signing this Acknowledgment of Paternity, I give up my right to establish paternity by genetic testing at a
later time.
Mother signature
Date signed
Father signature
Date signed
Witness signature
Printed name
Witness signature
Printed name
Witness address
Witness address
Parents cannot witness each other's signatures. Witnesses cannot be related to mother or father. Distribution of copies: white
to OSDH Division of Vital Records, yellow to OKDHS/Oklahoma Child Support Services, pink to Mother, gold to Father.
OKDHS revised 10-1-12
03PA209E (OCSS-209)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 2