Get In Form 54763

In Form 54763 is the application for a search of paternity affidavit provided by the Indiana State Department of Health. This guide offers step-by-step instructions to assist users in completing the form accurately and efficiently online.

Follow the steps to successfully complete the In Form 54763 online.

1. Press the ‘Get Form’ button to access the form and load it in your online editor.
2. Begin by providing the full name at birth of the individual named on the paternity affidavit.
3. Indicate if the birth could be recorded under any other name by answering yes or no and supplying the alternate name if applicable.
4. Enter the city and county of birth, as well as the name of the hospital if known.
5. Fill in the date of birth using the format month, day, year.
6. Provide the age of the individual on their last birthday.
7. List the full name of the father and the full name of the mother, including the maiden name of the mother.
8. Specify the purpose for which the record will be used.
9. Indicate your relationship to the child named on the affidavit.
10. Sign the application and provide your mailing address, ensuring it matches the identification you will submit.
11. Enter your daytime telephone number, including area code.
12. Date your application by entering today’s date in the format month, day, year.
13. Prepare your application by including a photocopy of valid identification, a check or money order made payable to the Indiana State Department of Health, and send everything to the provided address.

Complete your documents online to ensure a smooth submission process.