Acknowledgment Of Paternity (Aop) Inquiry Request Form - Texas Department Of State
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1ACKNOWLEDGMENT OF PATERNITY (AOP) Budget: ZZ712
INQUIRY REQUEST FORM
Fee Received: ______
___ Positive Search
___ Negative Search
Date Mailed/ Fax: _______
The AOP Registry only includes Acknowledgments of Paternity filed from September 1,
1999 to the present.
Name of Child: ________________________________________ Date of Birth:_______
City or County of Birth: ________________________________
Mother’s complete name: _______________________________ Date of Birth:________
Biological Father’s name: _______________________________ Date of Birth:________
Check One:
Certified Copy of AOP
Certified Copy of AOP Rescission
Name and address of Person making the Inquiry:
First
Middle
Last
Address
City
State
Zip Code
(
)
(
)
Daytime Telephone Number
Fax number
Family Code §160.313 allows access to AOP’s to the following individuals/agencies:
Relationship: ___ Mother ___ Father ___ Presumed Father ___Court Ordered for Attorney
Release: I authorize you to give the copy of the above-identified Acknowledgment of Paternity form or Rescission of
Acknowledgment of Paternity form to:
_____________________________________________________________________________
___________________________________________
______________
SIGNATURE OF REQUESTOR
DATE
This inquiry request requires a search fee. If paying by credit card, the fee is $12.25. If paying by check or money
order, the fee is $10.00. Make check or money order payable to Texas Department of State Health Services
(DSHS) -ZZ712. Mail completed form and fee to the address below. This inquiry may also be faxed to 512-776-
7164 and paid with a MasterCard, Visa, Discover, or American Express.
If faxed: ___M/C ___VISA ___DISCOVER
CARD # ______________________________________ EXP DATE ________________
___American Express
NAME OF CARDHOLDER __________________________________________________
Mail To:
CARDHOLDER ADDRESS__________________________________________________
AOP Registry
Vital Statistics Unit, MC 1966
_________________________________________
P.O. BOX 12040
Austin, Texas 78711-2040
3 - DIGIT SECURITY CODE _______________(Found on back of card)
CARDHOLDER PHONE NUMBER,
INCLUDING AREA CODE ___________________________________________________
***IMPORTANT: A copy of government-issued photo identification must be
provided with this request [25 TAC §181.1(13)] ***
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