Fill and Sign the Minnesota Paternity Form

State of Minnesota District Court County Judicial District: Court File Number: Case Type Family Court In the Matter of: Petitioner DENIAL OF PATERNITY vs. Respondent I, , state as follows: 1. I am _______ years of age; and reside at (Street Address) (City) (State) (County) 2. I have been advised _____________________________ is the mother of a ______________ child (Male/Female) named ____________________________ born or expected to be born on _________________ and I have registered with the Father’s Adoption Registry as father of this child. 3. I now deny that I am the father. My denial at this time will not subject me to any criminal liability. 4. I enter my appearance in this case and waive service of summons and other pleading. OATH I have been sworn and say under oath I have read and understand this form. The facts it contains are true and correct to the best of my knowledge. I have signed this document freely and voluntarily. Sworn/affirmed before me this _________ of _____________, _______ Notary Public/Court Deputy ADO102 State ENG Rev 9/99 www.courts.state.mn.us/forms Page 1 of 1Signature: Sign only in presence of notary or court clerk Print Name: Street Address: City/State/Zip: Telephone: (______)