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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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.
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.
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)
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:
Mother,
SECTION III. FATHER'S INFORMATION
Name of Father - First, Middle, Last
Support,
Father's Address
Father's Phone Number
Father's Place of Birth - City, State
Father's Social Security Number
Childto
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
Records,
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
DISTRIBUTION
GUARDIAN'S SIGNATURE (If Father under age 18)
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
Page 1 of 2
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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
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.
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.
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.
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.
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.
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.
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.