Fill and Sign the Acknowledgment Paternity Form

IN THE ______________________COURT OF ___________________ (County), ___________________________________________(State) ______________________________________________ PETITIONER V. CAUSE NO. _____-______ ______________________________________________ RESPONDENT I, __________________________________________ , Respondent in the above- entitled action, acknowledge that I am the father of the male child, _________________ __________________________________ , born on ________________________ (date), in _____________________________________________________________________ ________________________________ (city, county, state). This child was born to ______________________________________________ (Petitioner), who then resided at _______________________________________________________________________________________________________________________________ (street address, city, county, state, zip code). . I have been advised of and waive my right to a trial on the issue of paternity and to an attorney to represent me on the issue of paternity both at the trial on the issue of paternity and in any action for support. Respectfully submitted ____________________________________ RESPONDENT STATE OF ___________________________________________ COUNTY OF _______________________________ Personally appeared before me, the undersigned authority in and for said County and State, on this _____ day of _____________________________, 20__, within my jurisdiction, the within-named _____________________________________________ (Respondent), who acknowledged that he executed the above and foregoing instrument. ____________________________________ NOTARY PUBLIC My Commission Expires: Certificate of Service This is to certify that I, _____________________________________________ (Respondent), have this date served a true and correct copy of the above and foregoing Acknowledgment of Paternity and Waiver of Trial by U.S. Mail, postage fully prepaid, to the following counsel of record for Petitioner: ___________________________________________________ (Name of Attorney) Post Office Box ___________ ________________________________________________________________________ _____________________________City, State, Zip Code This the ____day of ______________________________, 20___. Respectfully Submitted, ______________________________ Respondent