Official Louisiana Paternity Template in PDF Fill Out My Document Online

Official Louisiana Paternity Template in PDF

The Louisiana Paternity form is a legal document used to establish the paternity of a child born out of wedlock. By completing this form, both parents can acknowledge the biological father’s rights and responsibilities, ensuring his name appears on the child’s birth certificate. Understanding the implications of this form is crucial; therefore, it is advisable to fill it out carefully and accurately.

To begin the process of establishing paternity, click the button below to fill out the Louisiana Paternity form.

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Document Overview

Fact Name Fact Description
Governing Law The Louisiana Acknowledgment of Paternity Affidavit is governed by Louisiana Revised Statutes R.S. 40:34B.(1)(a)(vii).
Purpose This form establishes paternity, allowing the biological father's name to be placed on the child's birth certificate.
Voluntary Signing Signing the affidavit is voluntary. It is recommended to consult an attorney before signing.
Marital Status Requirement The mother must have lived separate from her husband for at least 180 days prior to the child's conception to use this affidavit.
Genetic Testing Either party may request a genetic test to confirm biological paternity before signing the affidavit.
Legal Consequences Once signed, this acknowledgment has the same legal effect as a court order establishing paternity and may lead to child support obligations.

Detailed Steps for Writing Louisiana Paternity

Filling out the Louisiana Paternity form is an important step in establishing legal parentage. Once completed, this form will help ensure that the biological father's name appears on the child's birth certificate, which is crucial for legal rights and responsibilities. Follow these steps carefully to fill out the form correctly.

  1. Read the Notice: Before you start, read and initial the "Notice of Alternatives, Rights and Responsibilities." This is important for understanding what signing the form entails.
  2. Child's Information: In Section I, fill in the child's name (first, middle, last) as it appears on the birth certificate. Include the date of birth (month, day, year) and place of birth (city, state, name of hospital).
  3. Preferred Name: Enter the child's name as the parents want it to appear on the birth certificate.
  4. Mother's Information: In Section II, provide the mother's full name (including maiden name), date of birth, address, phone number, and place of birth. Circle the mother's race and provide her Social Security number.
  5. Marital Status: Indicate whether the mother was married at the time of the child's birth. If yes, include the name and address of the husband.
  6. Health Insurance: If applicable, provide information about the mother's health insurance, including the insurance company name and policy number.
  7. Father's Information: In Section III, fill out the father's full name, date of birth, address, phone number, place of birth, and race. Include the father's Social Security number and employer information.
  8. Guardian Information: If the father is under 18, include the guardian's name, address, and signature.
  9. Health Insurance for Father: If applicable, provide the father's health insurance details, including the insurance company name and policy number.
  10. Signatures: Both the mother and father must sign the affidavit, affirming that all statements are true. If applicable, the husband/ex-husband of the mother must also sign, confirming he is not the biological father.
  11. Notary Section: Finally, have the document notarized. This includes signatures from witnesses and the notary public, along with their registration number and commission expiration date.

After completing the form, ensure all sections are filled out accurately. Once notarized, the form can be submitted as required. If you have any questions or need assistance, don't hesitate to reach out for help.

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STATE OF LOUISIANA

ACKNOWLEDGMENT OF PATERNITY AFFIDAVIT

CHILD BORN OF MARRIAGE

NOTICE: You must read and initial the NOTICE OF ALTERNATIVES, RIGHTS AND RESPONSIBILITIES before you sign the affidavit.

 

 

 

SECTION I. CHILD'S INFORMATION

 

 

 

 

 

This is a legal document. Complete in ink and do not alter.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Child - First, Middle, Last (As it appears on birth certificate)

 

 

 

Date of Birth - (Month, Day, Year)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Place of Birth - City, State

 

 

 

 

 

 

 

Name of Hospital

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Child - First, Middle, Last (As the parents want it to appear on birth certificate)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION II. MOTHER'S INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

husband.-

 

 

Name of Mother - First, Middle, Last

 

 

 

 

 

(Maiden Name)

 

Date of Birth - (Month, Day, Year)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mother's Address

 

 

 

 

 

 

 

 

 

 

 

Mother's Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ex

 

 

Mother's Place of Birth - City, State

 

 

 

Race (Circle) American Indian, Black, White, Asian

 

Mother's Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If Other, List:

 

 

 

 

 

 

 

 

 

Husband/&

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Circle One:

Yes

No

 

 

 

 

 

 

Mother's Occupation

 

 

 

 

 

 

 

Mother's Employer - Name & Address

 

 

 

 

 

 

 

 

 

 

 

 

 

Was Mother Married at Time of Birth

If Yes, Name and Address of Husband

 

 

 

 

 

 

 

Father

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Does Mother Have Health Insurance

If Yes, Name of Insurance Company and Policy No.

 

State Medicaid:

 

 

 

 

 

Circle One:

Yes

No

 

 

 

 

 

 

 

Circle One:

 

Yes

No

 

Mother,

 

 

SECTION III. FATHER'S INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Father - First, Middle, Last

 

 

 

 

 

 

 

Date of Birth - (Month, Day, Year)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Support,

 

 

Father's Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Father's Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Father's Place of Birth - City, State

 

 

 

Race (Circle) American Indian, Black, White, Asian

 

Father's Social Security Number

 

 

 

 

 

 

 

 

 

 

 

Childto

 

 

 

 

 

 

 

 

 

 

 

 

 

If Other, List:

 

 

 

 

 

 

 

 

 

 

 

Father's Employer - Name & Address

 

 

 

 

 

 

Father's Occupation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Copies

 

 

Father's Guardian (If Father under age 18) Print Name

Guardian's Address

 

 

Guardian's Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Does Father Have Health Insurance

If Yes, Name of Insurance Company and Policy No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Records,

 

 

Circle One:

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

name appear on the Certificate of Birth of my child. I declare and affirm that I lived separate and apart from the legal presumptive father for a

minimum of one hundred

 

 

 

 

MOTHER: I certify that I am the MOTHER of the child named above and that all statements made herein are true and correct to the best

of my knowledge. I am

 

 

 

 

signing this Affidavit voluntarily and of my own free will. I acknowledge that the man named above is the biological father of my child. I give my consent to have his

Vital

 

and eighty days prior to the time of conception and have not reconciled since the beginning of the one hundred and eighty-day period.. I further acknowledge that I

 

have received oral and written notice of the legal rights and consequences resulting from my acknowledging the paternity of my child and I understand this notice.

 

 

of

__________________________________________

 

 

 

___________________________________________

 

 

 

 

Registrar

 

MOTHER'S SIGNATURE

 

 

 

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WITNESS ____________________________________

 

 

 

WITNESS _____________________________________

 

 

 

 

to

 

State of Louisiana, Parish of _____________________________________

______________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature then PRINT name of Notary

 

 

 

 

Original

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signed and Affirmed before me on the

 

 

day of

___________________________

_______________________

 

 

 

 

 

 

,

 

.

 

 

 

 

 

State Notary Registration Number

 

My Commission expires on

 

 

COPIES:

 

 

 

 

 

 

 

 

FATHER: I certify that I am the biological FATHER of the child named above and that all statements made herein are true and correct to the best of my knowledge. I

 

am signing this Affidavit voluntarily and of my own free will. I acknowledge that I have received oral and written notice of the legal rights and consequences resulting

 

 

 

 

 

 

 

 

from my acknowledging the paternity of my child and I understand this notice.

 

 

 

 

 

 

 

 

 

OF

__________________________________________

 

 

 

___________________________________________

 

 

 

 

 

FATHER'S SIGNATURE

 

 

 

 

 

 

 

DATE

 

 

 

 

 

 

 

DISTRIBUTION

__________________________________________

 

 

 

___________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GUARDIAN'S SIGNATURE (If Father under age 18)

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

WITNESS ____________________________________

 

 

 

WITNESS _____________________________________

 

 

 

 

 

 

 

 

State of Louisiana, Parish of _____________________________________

______________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature then PRINT name of Notary

 

 

 

 

 

 

 

 

Signed and Affirmed before me on the

 

 

day of

___________________________

_______________________

 

 

 

 

 

 

,

 

.

 

 

 

 

 

State Notary Registration Number

 

My Commission expires on

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HUSBAND/EX-HUSBAND OF THE MOTHER: I certify that I was married to the mother of this child at the time of conception or birth; however, I am not the biological

 

 

 

 

father. Further, I declare and affirm that I lived separate and apart from the mother for a minimum of one hundred and eighty days prior to the time of conception and

 

 

 

 

have not reconciled with her since the beginning of the one hundred and eighty-day period.

 

 

 

 

 

 

 

 

 

 

__________________________________________

 

 

 

___________________________________________

 

 

 

 

 

 

 

 

HUSBANS/EX-HUSBAN'S SIGNATURE

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

WITNESS ____________________________________

 

 

 

WITNESS _____________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State of Louisiana, Parish of _____________________________________

______________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature then PRINT name of Notary

 

 

 

 

 

 

 

 

Signed and Affirmed before me on the

 

 

day of

___________________________

_______________________

 

 

 

 

 

 

 

,

 

 

.

 

 

 

 

 

State Notary Registration Number

 

My Commission expires on

 

 

Page 1 of 2

VRR-44 3-P 05/10

NOTICE OF ALTERNATIVES, RIGHTS AND RESPONSIBILITIES

This is a legal document. Signing the form is voluntary. Since this form has legal consequences, you may want to consult an attorney before signing.

When this Acknowledgement is properly completed and signed, the biological father's name is entered on the birth certificate in place of the name of the husband of the mother and the man becomes the legal father of the child. This acknowledgement has the same effect as a court order establishing paternity and can be used as a basis for entering a child support order.

If either of you is not sure that this man is the biological father of this child, you should not sign the form. You should have a genetic test.

Mothers who are married to someone other than the biological father or were married to someone other than the father when the child was conceived, or have been divorced for less than three hundred days must have the agreement of their husband/ex-husband to execute this affidavit. Further, the use of this affidavit is limited to cases where the husband and the mother lived separate and apart continuously for a minimum of one hundred and eighty days prior to the conception of the child and have not reconciled since the beginning of the one hundred eighty-day period. If the agreement of the husband cannot be obtained or if the couple cannot meet the statutory requirements, this affidavit cannot be used. In order for the biological father's name to be added to the birth certificate, a court must establish paternity in accordance with R.S.40:34B.(1)(a)(vii)

RIGHTS AND RESPONSIBLITIES OF A PARENT

Either party has the right to request a genetic test to determine if the alleged father is the biological father of the child.

The alleged father has the right to consult an attorney before signing an acknowledgement of paternity.

If the alleged father does not acknowledge the child, the mother has the right to file a paternity suit to establish paternity. After the alleged father signs an acknowledgement of paternity, he has the right to pursue visitation with the child and the

right to petition for custody.

Once an acknowledgement of paternity is signed, the father may be obligated to provide child support for the child.

Once an acknowledgement of paternity is signed, the child will have inheritance rights and any rights afforded children born

in wedlock.

A party who executed a notarial act of acknowledgement may rescind the act, without cause, before the earlier of the

following:

-Sixty days after the signing of the act, in a court hearing for the limited purpose of rescinding the acknowledgment.

-A court hearing relating to the child, including a child support proceeding, in which the father is involved.

Thereafter, the acknowledgement of paternity may be voided only upon proof, by clear and convincing evidence, that such act was induced by fraud, duress, or material mistake of fact, or that the father is not the biological father.

BENEFITS FOR YOUR CHILD

Every child has the right to know his or her mother and father and benefit from a relationship with both parents.

Both of your names will appear on the child's birth certificate.

It will be easier for your child to learn medical histories of both parents and to benefit from health care coverage available to you.

It will be easier for your child to receive benefits such as dependent or survivor's benefits from the Veteran's Administration or from the Social Security Administration as well as share any estate should you die.

To indicate that you have read and understood this notice of alternatives, rights and responsibilities, please initial below. If you require further assistance you may call us at (504) 593 - 5100.

Mother’s Initials ________________________

Father’s Initials ________________________

VRR-44 3-P (05/10)

Page 2 of 2

Misconceptions

  • Misconception 1: The Louisiana Paternity form is only for unmarried parents.
  • This form can also be used by parents who are married but need to establish paternity for legal reasons. It helps clarify the biological father's rights and responsibilities.

  • Misconception 2: Signing the form automatically makes the father responsible for child support.
  • While signing the form does establish paternity, it does not automatically result in child support obligations. A separate child support order may still be necessary.

  • Misconception 3: The biological father's name cannot be added to the birth certificate if the parents are not married.
  • The form allows the biological father's name to be placed on the birth certificate, regardless of the parents' marital status, provided the form is properly completed.

  • Misconception 4: The mother’s husband must always agree to the acknowledgment of paternity.
  • The husband’s agreement is only necessary if the mother was married at the time of conception or birth. If the parents lived apart for the required period, this may not be needed.

  • Misconception 5: Once signed, the acknowledgment of paternity cannot be changed or revoked.
  • Acknowledgments can be rescinded within a specific time frame, such as sixty days after signing, or in certain court proceedings. This provides a way to address any concerns that arise.

Documents used along the form

When completing the Louisiana Paternity form, several other documents may also be necessary or beneficial to ensure that all legal aspects of paternity are addressed. Below is a list of commonly used forms and documents that may accompany the Louisiana Paternity form.

  • Birth Certificate: This document officially records the birth of the child. It includes essential details such as the child's name, date of birth, and parents' names. It is crucial for establishing legal identity and may be required for various applications, including school enrollment and health insurance.
  • Child Support Guidelines: This document outlines the legal framework for determining child support obligations. It provides information on how support amounts are calculated based on income, custody arrangements, and other factors. Understanding these guidelines can help both parents navigate their financial responsibilities.
  • Power of Attorney Form: This document allows an individual to designate another person to act on their behalf in legal matters, including decisions related to paternity and child support. For a comprehensive guide on this document, visit UsaLawDocs.com.
  • Genetic Testing Results: If there is uncertainty regarding paternity, genetic testing can provide conclusive evidence. This document presents the results of the DNA test, confirming or denying biological parentage. It is often used in court proceedings or negotiations regarding custody and support.
  • Custody Agreement: If parents are not living together, a custody agreement outlines the terms of child custody and visitation. This document addresses where the child will live, how decisions will be made, and visitation schedules. It is essential for ensuring that both parents' rights and responsibilities are clear.
  • Health Insurance Documentation: This form details the health insurance coverage available for the child. It includes information about the provider, policy number, and coverage details. Having health insurance is vital for the child's well-being and can affect decisions regarding medical care and expenses.

Collectively, these documents play a significant role in establishing paternity and ensuring that the rights and responsibilities of all parties involved are clearly defined. Understanding each document's purpose can help parents navigate the complexities of paternity and child support effectively.