Fill and Sign the Form 818

Form 818 Name is the biological mother of the following child/ren: 1. County and is a resident of Name is the biological father of the child/ren named in 2. - State County City/Town Section # 1 and is a resident of Name Date On or about became pregnant with the child/ren named in Paragraph # 1. 4. The following facts support my allegations of parentage: to a. 1. We lived together from to 2. The alleged father lived with the child from 3. The alleged father visited the child on the following occasions: 1. The alleged father has provided food, clothing or financial support for the child. b. 2. The alleged father claimed the child on his tax return. c. The alleged father offered to pay for an abortion; offered to pay for medical expenses related to the birth of the child. is the father of the child as follows: d. I have always asserted that he was that I was e. On (date), I told the father of the child. PARENTAGE AFFIDAVIT Vermont Docket Number County Family Court Plaintiff Defendant VS. 3. , Paid Rev. 1/04 SML Name of Child Date of Birth Name of Child Date of Birth Name of Child Date of Birth Name of Child Date of Birth Name of Child Date of Birth Name of Child Date of Birth has admitted that he is the father of the child as follows: f. The alleged father visited the mother the child at the hospital during the birth. h. The alleged father was present at the birth of the child. Copy attached. i. The alleged father is named on the birth certificate. k. The alleged father sent cards/correspondence regarding the pregnancy and birth of the child as follows: (Copies attached) l. The alleged father provided gifts for the child as follows: m. The child resembles the alleged father as follows: n. Other: Date Signature Subscribed and sworn to before me this day of 20 Notary Public Expiration Date Rev. 1/04 SML j. The alleged father has acknowledge in writing that he is the father of the child as follows: (Copies attached) , g. Form 818 back of page 1