Voluntary Request For Order Of Paternity Page 4

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Case No:_________________
We swear or affirm that the information on this document is true and correct to the best of our knowledge and belief.
_____________________________
___________________________________________
Date
(Mother’s Signature
STATE OF ARIZONA
)
)ss:
COUNTY OF _________________ )
Subscribed and sworn or affirmed and acknowledged before me this date:______________________
My Commission Expires:____________________
___________________________________________
NOTARY PUBLIC / DEPUTY CLERK
_____________________________
___________________________________________
Date
(Father’s Signature)
STATE OF ARIZONA
)
)ss:
COUNTY OF _________________ )
Subscribed and sworn or affirmed and acknowledged before me this date:______________________
:________________
___________________________________
My Commission Expires:
NOTARY PUBLIC/DEPUTY CLERK
Page 4 of 4
11/2/2006

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