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Get Declaration Of Paternity

(see bottom of page). PLEASE READ PAGE 2 BEFORE COMPLETING. SECTION A ALL PARTS OF SECTIONS A & B MUST BE COMPLETED AND SECTION D WITNESSED NAME OF CHILD FIRST MIDDLE LAST SEX OF THE CHILD DATE OF BIRTH (Month, Day, Year) Child HOSPITAL NAME Place of Birth Father s Information CITY COUNTY STATE NAME OF FATHER FIRST MIDDLE LAST DATE OF BIRTH (Month, Day, Year) SOCIAL SECURITY NUMBER STATE OR FOREIGN COUNTRY OF BIRTH CURRENT ADDRESS (Number, Street, City, State Zip).

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