Completion of the Voluntary Acknowledgment of Parentage Form

The following information are instructions provided to guide you to complete the Voluntary Acknowledgment Form. Please use black ink only (including the notarization).

Child’s information

Please follow these instructions for Child's information:

• The child’s information must be exactly as it appears on the original birth record
• Provide the child’s social security number (if there is no social security number you must state “none” in the area provided for the social security number)
• On the first line of the form asking for the “child’s name,” please be sure to copy the name of the child exactly as it appears on the original birth record.
• The section requesting “name of child to appear on the amended birth record” must also reflect the name of the child exactly as it appears on the original birth record unless a change of the child’s name has been discussed and approved by the city clerk staff.

Mother's Information

Please follow these instructions for Mother information:

• All of the mother’s information must be exactly as it appears on the original birth record (use only the address that appears on the birth record even if your current address is different)
• Be sure to provide your social security number (if you don’t have a social security number you must state “none” in the area provided for the social security number)
• Be sure to provide your maiden name as stated on the original birth record

Father’s information

Please follow these instructions for Father information:

• Be sure to provide your mother’s maiden name in the area where it is requested
• Be sure to provide your social security number (if you don’t have a social security number you must state none in the area provided for the social security number)

Both Mother & Father

• Be sure that both mother and father initial and date the back of the form
• Delay will result if signatures are not notarized or if there is any missing, incomplete, information or if the form is not completed in ‘black ink’

Additional Amendment & Correction

Once a correct and complete voluntary of acknowledgment form has been received an additional amendment and correction form must be completed before the birth record can be amended.