Affidavit
Homepage ⇨ Fill Your Indiana Paternity Affidavit 44780 Form
Structure

Establishing paternity is a vital step in recognizing and securing the legal rights of a child and their parents in Indiana. The Indiana Paternity Affidavit 44780 form plays a crucial role in this process, serving as the official document for voluntary acknowledgment of paternity. This crucial form not only paves the way for a father's name to be added to the birth certificate but also has significant implications for child support, custody, and visitation rights. Understanding its importance, this form is typically completed at the hospital shortly after a child's birth, although it can also be filled out at a later date. It represents a mutual agreement between the mother and the presumed father, acknowledging that he is indeed the biological father of the child. The completion of this document is a powerful step towards establishing a legal relationship between a father and his child, making it essential for parents to comprehend its contents fully, the process involved, and its substantial impact on all parties' rights and responsibilities.

Document Sample

PATERNITY AFFIDAVIT – HOSPITAL USE

State Form 44780 (R7 / 11-17)

INDIANA STATE DEPARTMENT OF HEALTH

Local Health Department Number

File Date (mm/dd/yyyy)

State File Number

 

 

 

Reset Form

Statutory Authority IC 16-37-2 Confidential: IC 16-37-1-10

PA Number

Before I signed any section of this affidavit I was allowed to review it alone and without the presence of the person listed in Section B. Also, I was given the opportunity to consult with an adult of my choosing.

Signature of Mother

Before I signed any section of this affidavit I was allowed to review it alone and without the presence of the person listed in Section C. Also, I was given the opportunity to consult with an adult of my choosing.

Signature of Father

SECTION A – ACKNOWLEDGEMENT OF PATERNITY

We, ____________________________________________ and ____________________________________________ have read and understand the

Father’s full legal name

Mother’s full legal name

consequences, alternatives, rights and responsibilities regarding this affidavit and being duly sworn upon oath depose and say:

I, ______________________________________ am the biological father of _________________________________________, the Child referred to in

Father’s full legal nameChild’s full name at birth – last name same as Mother

SECTION D of this affidavit who was born on __________________ in ________________________ at ________________________, ____________

(mm/dd/yyyy)CityCountyState

________________________________________________________________________________________________________________________.

Hospital or address of location of birth

I, ___________________________________________ whose maiden name is ___________________________________________, am the mother

Mother’s full legal nameMother’s full maiden name

of the child referred to in Section D of this affidavit and that ____________________________________________ is the biological father of that child.

Father’s full legal name

Therefore, I wish for the birth certificate to identify him as the father.

SECTION B – BIOLOGICAL FATHER’S FACTS OF BIRTH

Full Legal Name

 

 

Social Security Number (Pursuant to IC 16-37-2-2.1 (e)(2)(B))

 

Race (optional)

 

 

 

 

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

Place of Birth (city, state,

and county)

 

 

 

 

 

 

 

 

 

 

 

Current Address (number and street, city, state, and ZIP

code)

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

(

)

Name of employer (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of employer (number and street, city, state, and ZIP code) (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

Policy number (optional)

 

 

Medical insurance company (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION C – BIOLOGICAL MOTHER’S FACTS OF BIRTH

 

 

Full Legal Name

 

 

Social Security Number (Pursuant to IC 16-37-2-2.1 (e)(1)(B))

 

Race (optional)

 

 

 

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

Place of Birth (city, state,

and county)

 

 

 

 

 

 

 

 

 

 

 

Current Address (number and street, city, state, and ZIP

code)

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

(

)

Name of employer (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of employer (number and street, city, state, and ZIP code) (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

Policy number (optional)

 

 

Medical insurance company (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION D – CHILD’S NAME ON INDIANA CERTIFICATE OF BIRTH

 

 

It is our mutual desire that the name of our child on the Indiana Certificate of Birth shall be recorded as:

 

 

 

 

 

 

 

 

 

 

 

First

 

Middle

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

Gender of Child

 

 

 

If known, last four (4) digits

child’s Social Security Number

 

 

Male

Female

Not Determined

 

 

 

X X X - X X -

 

 

Page 1 of 2

Local Health Department Number

File Date (mm/dd/yyyy)

State File Number

PA Number

SECTION E – NOTICE OF CONSEQUENCES, ALTERNATIVES, RIGHTS AND RESPONSIBILITIES

By signing this affidavit, I acknowledge that I have read and understand all of the following:

1.A man should NOT sign this form if he is not sure he is the biological father. I may seek a genetic test before signing this form. Signing a Paternity Affidavit is voluntary. I may not be able to reverse paternity and the legal responsibilities of support associated with it, once I sign a Paternity Affidavit.

2.I may sign a Paternity Affidavit at the local Health Department at any time before the child’s emancipation, as long as there is no father listed on the birth certificate.

3.A woman who knowingly or intentionally falsely names a man as the child’s biological father commits a Class A misdemeanor.

4.I received both written and verbal information about the legal effects of signing a Paternity Affidavit.

5.Since this form has legal consequences, I may want to consult an attorney before signing.

6.This affidavit is void if signed more than seventy-two (72) hours after the birth of the child or if signed after the mother has executed a consent to adoption and a petition to adopt has been filed.

7.If I am the presumed father and do not establish paternity now, but want the right to notice and a hearing regarding any adoption of the child, I must register with the Indiana Putative Father Registry through the Indiana State Department of Health.

8.If the mother is receiving or plans to receive public assistance (TANF or Medicaid), she may be required to cooperate in establishing paternity and obtaining a support order or face losing those benefits.

9.If I do not sign a Paternity Affidavit and am unsure about the paternity of the child, I may contact the Prosecuting Attorney’s office in my county for help establishing paternity. They will help arrange tests to establish paternity.

10.The custodial party may contact the Prosecuting Attorney’s Office in their county for the child support services below through the IV-D program.

●

Establishing paternity

●

Getting a court order for the payment of child support and medical support

●

Finding the absent parent

●

Enforcing child support and medical support orders

11.The completion of this legal document establishes paternity with no further court action required and gives the mother or the IV-D agency the right to obtain a child support order requiring the father to pay support.

12.The father will have parenting time as outlined by the Indiana Parenting Time Guidelines, unless a court rules differently. See www.in.gov/judiciary/rules/parenting.

13.A man has the right to withdraw/rescind his acknowledgment of paternity only within sixty (60) days of the date the Paternity Affidavit is completed. To do so he must file an action in a court with jurisdiction over paternity and may need to submit to and pay for genetic testing per IC 16-37-2-2.1(k- l). After sixty (60) days the father may not be able to reverse paternity, even if genetic tests prove he is not the biological father.

Signature of Mother

Signature of Father

Date (mm/dd/yyyy)

Date (mm/dd/yyyy)

SECTION F – ESTABLISHMENT OF JOINT LEGAL CUSTODY

If both mother and father agree, they may complete this section of the Paternity Affidavit to elect to share joint legal custody of the child named in Section D. Joint legal custody means both mother and father share authority and responsibility for the major decisions concerning the child’s upbringing, including the child’s education, health care and religious training. Also mother and father have equal access to the child’s school and medical records.

(Both signatures are required to share joint legal custody.)

1.

I wish to share joint legal custody of this child with the father listed in Section B of this affidavit.

Signature of Mother (go to 2, then 3): ____________________________________________________

I wish to share joint legal custody of this child with the mother listed in Section C of this affidavit. Signature of Father (go to 2, then 3): _____________________________________________________

2.If you have chosen to share joint legal custody, the mother still has primary physical custody of the child unless another determination is made in a

court proceeding under Indiana Code 31-14.

Initials of Mother: _________ Initials of Father: _________

3.If you agree to share joint legal custody, you MUST submit the results of a genetic test, performed by an accredited laboratory no later than sixty (60) days after the child’s birth, that indicate the father listed in Section B is the biological father of the child. Otherwise, your agreement to share joint legal custody will be void. However the establishment of paternity IS still VALID. Initials of Mother: _________ Initials of Father: _________

4. I do NOT wish to share joint legal custody of this child and I understand this affidavit may still be used to establish paternity if the other sections are properly completed. (Only one signature is required but both may sign.)

Signature of Mother (go to 5): ____________________________________________________

Signature of Father (go to 5): ____________________________________________________

5.If you have chosen NOT to share joint legal custody, the mother has SOLE legal custody unless another determination is made in a court proceeding under Indiana Code 31-14. However the establishment of paternity (SECTIONS A - E) IS still VALID.

Initials of Mother: _________ Initials of Father: _________

Subscribed and sworn to before me, the undersigned, a Notary Public, in and for said county, this ________ day of _______________, 2________.

Signature of Notary

Printed Name of Notary

My Commission Expires (mm,dd,yyyy)

County of Residence

Page 2 of 2

▼ Indiana Paternity Affidavit 44780 File

File Attributes

Fact Description
1. Purpose The Indiana Paternity Affidavit 44780 form is used to legally establish the paternity of a child born out of wedlock in the state of Indiana.
2. Voluntariness Signing the form is voluntary and should be agreed upon by both parents to establish paternity without going to court.
3. Signatory Requirements Both the biological mother and the father are required to sign the affidavit for it to be valid.
4. Witness Requirement The signing of the form must be witnessed by an authorized individual, such as a notary public or a qualified witness under Indiana law.
5. Rescission Period Either parent has the right to rescind (cancel) the affidavit within 60 days of signing it, or until the date of an administrative or judicial proceeding relating to the child (whichever is earlier).
6. Legal Impact Once established, the affidavit grants the father legal paternity rights and responsibilities, including custody rights, visitation rights, and child support obligations.
7. Amendment Process The affidavit can be amended only under specific conditions, such as a court order or mutual agreement following a paternity test.
8. Governing Law The form and its procedures are governed by Indiana law, particularly the statutes concerning paternity establishment, amendment, and rescission.
9. Availability The form is available at Indiana hospitals, local health departments, and the state's Department of Health website.

Guidelines on How to Fill Out Indiana Paternity Affidavit 44780

Completing the Indiana Paternity Affidavit 44780 form is an essential procedure for parents wishing to establish paternity when the child's parents are not married. This legal document is a voluntary admission of paternity and is crucial for matters such as child support, custody, and visitation rights. It is important for both parents to fully understand the information they are providing, as this form has significant legal implications regarding the father's rights and responsibilities. Here are the steps needed to fill out the form accurately.

  1. Gather all necessary information, including both parents' full names, addresses, Social Security numbers, and the child's full name and date of birth.
  2. Enter the child's information at the top of the form, including their full name, and date of birth.
  3. Fill in the mother's information, including her full name, Social Security number, date of birth, and current address.
  4. Fill in the father's information, replicating the details required for the mother, such as full name, Social Security number, date of birth, and address.
  5. Both parents must read the rights and responsibilities section carefully to understand the legal implications of signing the affidavit.
  6. Sign and date the affidavit in the presence of a notary public. The form typically requires the signatures of both parents to be notarized to confirm their identities and their voluntary acknowledgment of paternity.
  7. Review the form to ensure all information is complete and accurate. Mistakes can lead to delays or issues with the legal recognition of paternity.
  8. Submit the completed form to the appropriate Indiana state office or the hospital where the child was born, as instructions specify.

After submitting the Paternity Affidavit, the legal process of recognizing paternity begins. It's important to follow any additional steps provided by the state or legal advisors. Establishing paternity can afford the father rights to custody and visitation, while also obligating him to support the child financially. This acknowledgment also plays a crucial role in the child's life, from health insurance coverage to inheritance rights.

Discover More on Indiana Paternity Affidavit 44780

What is Indiana Paternity Affidavit 44780?

The Indiana Paternity Affidavit 44780 form is a legal document that establishes the paternity of a child in the state of Indiana. When a child is born to unmarried parents, this form allows the father to be recognized legally as the child's parent. It is typically completed at the hospital shortly after the child's birth but can be filled out and submitted later at a local health department or the office of the county clerk.

Who should fill out the Indiana Paternity Affidavit 44780 form?

This form should be completed by the biological parents of a child when the parents are not married to each other. Both parents must agree to sign the affidavit voluntarily. It is essential for establishing the father's legal rights and responsibilities, including custody, visitation, and support obligations.

What information is needed to complete the form?

To correctly complete the Indiana Paternity Affidavit 44780 form, you will need to provide detailed information about both the mother and the father, including their full names, social security numbers, addresses, and dates of birth. Information about the child, such as the child's name, place of birth, and date of birth, is also required. Additionally, the form requires both parents' signatures, which must be witnessed by a notary public or a qualified hospital representative.

Can the Indiana Paternity Affidavit 44780 form be revoked?

Yes, the affidavit can be rescinded by either parent. To do so, a formal revocation must be filed within 60 days after the affidavit is signed. The revocation form should be submitted to the office where the original affidavit was filed. After the 60-day period, challenging the paternity established by the affidavit requires a court order, and the individual seeking revocation must present compelling evidence to dispute paternity.

Are there any fees associated with the Indiana Paternity Affidavit 44780 form?

No, there are no fees required to complete or file the Indiana Paternity Affidavit 44780 form. However, if a notary public's services are used outside of a hospital setting to witness the signing, the notary may charge a fee for their services. It is advisable to check in advance regarding any potential costs.

Common mistakes

Filling out the Indiana Paternity Affidavit 44780 form is a critical legal procedure that confirms a man as the legal father of a child. When completed correctly, it grants the father certain rights, responsibilities, and benefits regarding the child. However, errors in completing this document can lead to significant legal complications and emotional distress. Understanding common mistakes can help mitigate potential problems.

  1. Not reading the instructions thoroughly: The form contains specific directions that must be closely followed to ensure its validity. Many individuals rush through this step, missing critical details about how to properly complete and submit the form.

  2. Inaccurate information: Providing incorrect information, whether intentional or accidental, can have serious legal implications. It's crucial that every detail on the affidavit, from names and dates to addresses, is accurate and truthfully represented.

  3. Failure to sign in the presence of a notary: The affidavit must be signed in the presence of a notary public to be legally binding. Overlooking this requirement can invalidate the entire document.

  4. Omitting relevant details: Sometimes, individuals might skip sections they believe are not applicable or fill them out incompletely. This mistake can lead to the rejection of the affidavit, as complete information is necessary for its acceptance.

  5. Delay in submission: The affidavit has a specific timeframe within which it must be submitted to the appropriate Indiana state department. Procrastination or delays in filing can complicate the paternity establishment process.

It is always recommended to review the form multiple times and consult with a legal professional if there are any doubts or questions. This careful approach ensures that the rights and responsibilities established by the affidavit are appropriately secured.

Documents used along the form

When managing the Indiana Paternity Affidavit 44780 form, it's not unusual to require additional documents to support or complement your case. These can range from legal forms that confirm identity to those that help establish custody or child support arrangements. This guide aims to highlight other essential forms and documents that are frequently used alongside the Paternity Affidavit to make the process smoother and more comprehensive.

  • Birth Certificate Application: Following the establishment of paternity, it's often necessary to update or obtain a new birth certificate for the child that reflects this information.
  • Child Support Worksheet: This legal document helps parents understand how much child support may be owed. It calculates the obligation based on the parents’ incomes, childcare expenses, and health insurance costs.
  • Voluntary Acknowledgment of Paternity: Similar to the Paternity Affidavit, this form is another way to acknowledge paternity but is typically used directly at the hospital right after the child is born.
  • Application for Child’s Social Security Number: After paternity is established and the birth certificate is updated, parents might need to apply for a Social Security number for their child.
  • Parenting Time (Visitation) Guidelines: These documents outline recommended visitation schedules and guidelines to help parents and courts establish a visitation schedule that works in the best interest of the child.
  • Custody Agreement Form: In cases where the parents are not together, a custody agreement formally outlines who the child will live with and how decisions about the child will be made.
  • Order for Support: A legal document issued by a court that requires a parent to pay child support. This often comes after the paternity is legally established and takes into account both parents' financial situations.

Each of these documents plays a critical role in the broader context of establishing paternity and the related legal implications. Whether you're updating a birth certificate, setting up child support, or arranging custody and visitation, having the right documents prepared can greatly assist in navigating through these significant steps. It's always recommended to seek legal advice tailored to your specific situation to ensure that all necessary paperwork is accurately completed and filed.

Similar forms

The Indiana Paternity Affidavit 44780 form shares similarities with the Acknowledgment of Paternity (AOP) form used in many states. Both documents serve the purpose of legally establishing the paternity of a child when the parents are not married to each other at the time of the child’s birth. By signing these forms, the father acknowledges legal responsibility and the document becomes a crucial step in securing rights and responsibilities, including child support and custody matters.

Another related document is the Voluntary Declaration of Parentage or Paternity, commonly utilized in California. Like the Indiana Paternity Affidavit, this document also provides a means for unmarried parents to formally establish the paternity of their child. Signing this declaration has significant legal implications, granting the father parental rights and responsibilities, which parallels the objectives of the Indiana form in facilitating the recognition of the biological and legal father.

Birth Certificate Application forms also bear resemblance to the Indiana Paternity Affidavit, as they may require information regarding paternity to be filled out when a child is born. In some cases, the affidavit can be used to add the father's name to the birth certificate at a later time, highlighting the overlapping purpose of both documents in legally acknowledging parenthood.

Child Support Enforcement forms share a common goal with the Indiana Paternity Affidavit, in that establishing paternity is often a required step before a child support order can be established or enforced. These documents are instrumental in securing financial support for the child from the non-custodial parent, underlining the importance of legal paternity establishment in the process of ensuring the child's well-being.

Family Law forms related to custody and visitation rights have parallels with the Indiana Paternity Affidavit, as establishing paternity is a prerequisite for a father seeking custody or visitation rights. These forms, by acknowledging paternity, enable the father to legally assert his rights to participate in his child’s life, emphasizing paternity's critical role in family law matters.

The Petition to Establish Parental Relationship is another document similar to the Indiana Paternity Affidavit in purpose. This legal filing is used when parents wish to establish paternity through the court system, often in cases where there is a dispute or lack of agreement. While the affidavit allows for voluntary acknowledgment, the petition can result in a court-ordered DNA test to establish paternity, illustrating another route to the same objective of recognizing the legal father of a child.

Lastly, the Child Custody and Support Agreement forms are analogous to the Indiana Paternity Affidavit, as they often entail stipulations that can only be effectively implemented once paternity has been established. These agreements detail the terms of custody, visitation, and financial support agreed upon by both parents and are enforceable by law, highlighting the affidavit's foundational role in delineating parental rights and responsibilities.

Dos and Don'ts

Filling out the Indiana Paternity Affidavit (Form 44780) is an important step in acknowledging paternity. This document helps ensure that both parents are recognized by law and that the child receives benefits like health insurance and support. Below are some key do's and don'ts to help guide you through the process efficiently and accurately.

  • Do read the entire form carefully before filling it out. Understanding every section can help prevent mistakes.
  • Do provide accurate information. The details you include about the child, mother, and father must be correct and truthful.
  • Do use black ink when filling out the form. This makes the document clear and legible for official purposes.
  • Do double-check the form for any errors or omissions before submitting. Ensuring all information is correct and complete can prevent delays.
  • Don't leave any sections blank unless the form specifically instructs you to do so. Incomplete forms may be considered invalid.
  • Don't guess on information. If you're unsure about a detail, it's better to verify it before including it on the form.
  • Don't sign the form without fully understanding its implications. Signing the affidavit means you're agreeing to the legal responsibilities of paternity.
  • Don't forget to obtain a copy of the completed and signed form for your records. Keeping a copy ensures you have evidence of paternity acknowledgment.

Misconceptions

  • Misconception 1: Signing this form is the only step needed to establish paternity. Many people believe that once the Indiana Paternity Affidavit 44780 form is signed, paternity is fully established. While it's a significant step, both parents must understand this action's legal implications fully. Establishing paternity might also involve court proceedings, especially if disputes arise later.

  • Misconception 2: The form grants immediate custody rights to the father. It's a common misunderstanding that signing the form provides the father with immediate custody or visitation rights. Actually, this form primarily establishes paternity and the father's financial responsibility. Custody and visitation rights require separate legal actions through the courts.

  • Misconception 3: Either parent can sign the form at any time after the child's birth. Timing is critical. The state of Indiana has specific deadlines by which this form must be signed and submitted. Misunderstanding these timelines can lead to complications in establishing paternity.

  • Misconception 4: The form is only necessary if the parents are unmarried. While it's true that married parents are generally presumed to be the legal parents of a child, there are instances where a Paternity Affidavit might be necessary for married couples, such as in cases involving assisted reproduction or surrogacy.

  • Misconception 5: There are no consequences for signing the form without being certain about paternity. Signing the Indiana Paternity Affidavit 44780 form has significant legal implications, including financial responsibilities. If a man signs the document without being certain of his paternity, he may still be liable for child support until paternity is legally contested and disproved.

  • Misconception 6: The form automatically updates birth records to include the father's name. While filing the form is a step towards adding the father's name to the birth certificate, the process is not automatic. Parents may need to take additional steps or submit further documentation to have the father's name officially recorded on the child's birth records.

Key takeaways

The Indiana Paternity Affidavit Form 44780 is a legal document used within the state of Indiana to establish paternity for a child born to unwed parents. Understanding its significance and the correct way to fill it out ensures that the legal rights and responsibilities of both parents are recognized. Here are key takeaways about completing and utilizing this form:

  • Voluntary Process: Both parents must willingly sign the Indiana Paternity Affidavit. This act is a mutual agreement to acknowledge the paternity of the child without going through a court process.
  • Time Frame: Ideally, the form should be signed at the hospital immediately following the child's birth. However, it can also be completed at a local health department or county registrar later.
  • Accuracy is Crucial: When filling out the form, providing accurate and complete information is essential. Errors can complicate legal matters related to the child in the future.
  • Identification Required: Both parents need to present valid identification when signing the affidavit. This step is vital for verifying the identity of the parties involved.
  • Legal Implications: Upon signing, the father attains legal rights and responsibilities towards the child, including child support obligations and the right to seek custody or visitation.
  • No Force or Coercion: Signing the affidavit should be free from any pressure or coercion. Its voluntary nature ensures that both parties are in agreement without external influences.
  • Witnesses: The signature process often requires the presence of a neutral third party or a notary to witness the signing, enhancing the document's legal credibility.
  • Amendment Process: If a mistake is made on the affidavit, there are provisions for amending the information. However, this process can be complex and might require legal advice.
  • Revocation Period: Indiana law allows for a short revocation period where either parent can withdraw the affidavit if they change their mind shortly after signing.
  • Seek Legal Advice: Understanding the form's legal implications is crucial. Seeking legal advice before signing can prevent unforeseen legal issues related to parental rights and responsibilities.

Completing the Indiana Paternity Affidavit Form 44780 accurately and understanding the responsibilities it entails are foundational steps in legally acknowledging paternity. This document not only establishes paternity but also enables the child to have a legal relationship with both parents, vital for emotional and financial support.

Please rate Fill Your Indiana Paternity Affidavit 44780 Form Form
4.68
Superior
187 Votes

Popular PDF Forms

Cja 23 Financial Affidavit - Helps determine the financial eligibility of defendants for receiving legal representation at the expense of the government.

Ohio Temp Test - This form is an official step towards independence for young Ohio drivers, marking a significant achievement in their driver education.

De964 Certificate - The DL 90B must be notarized or signed in front of a Driver License employee, making it a legally binding affidavit.