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I understand the criminal penalties for making false statements and false swearing and do hereby attest to the truthfulness of the information provided. [False swearing is punishable by a fine, by imprisonment or both.] Insert your states statutes for perjury, false swearing, misrepresentation and fraud.

I understand that copies of this notarized Paternity Notification Affidavit must be sent to the putative father and all possible fathers listed on this affidavit via certified mail + restricted delivery + return receipt or similar service that requires Identification and signature on delivery. 


I acknowledge that I am the biological mother or legal guardian of the child listed in this Affidavit. This Paternity Acknowledgment Affidavit has been given of my own free will and volition, and I understand that under the Laws of the State of __________, and at some time in the future, I may be liable to furnish support for the child named herein, until said child has emancipated.

I understand that the child(ren) and I will be required to submit to genetic testing for paternity determination, and am so willing to cooperate, to establish paternity for the child. Except for legally adopted children and certain cases of births resulting from artificial insemination. See Paternity Testing section for more information.

PATERNITY TESTING: If paternity has not been determined by genetic testing, testing will be required to determine paternity. If the putative father is the biological father, the biological mother or legal guardian will have right of action for child support except for non-adopted children and certain pregnancies resulting from unauthorized artificial insemination. In all cases of artificial insemination, the mother or legal guardian must provide copy of notarized written consent to the procedure, signed by the biological mother, the putative father and the treating physician to have right of action for child support.

COST OF TESTING:  Initial fees for genetic testing will be split on a 50 percent basis by the biological mother or legal guardian and the putative father. If the putative father is not the biological father, he shall be reimbursed in full by the initiating party for all costs associated with defending the false allegation of paternity.


If any of the following conditions apply to the putative father, he shall be released from all responsibility for the child, including child support, arrears and other expenses:

The putative father is not the biological father based on paternity index below a ratio of 1,000 to 1.

The putative father is not the legally adopted father.

The putative father did not consent (written and notarized) to the artificial insemination, signed by his Wife, the biological mother and the treating physician. If this child is born by a surrogate mother using the putative father's sperm then his wife shall have cause of action for child support purposes.

PROOF OF NON-PATERNITY: If the putative father meets any of the criteria above for release of support, he will receive an official order of non-paternity and full release of all obligations for the child listed on this form.


Copyright © 2001-2011, Carnell Smith, , all rights reserved.

Maybe freely copied or used provided the attribution line is kept intact.


Paternity Fraud is a crime, crime does NOT PAY and neither should the victim!

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