NOTICE OF ALTERNATIVES, RIGHTS AND RESPONSIBILITIES
This is a legal document. Signing the form is voluntary. Since this form has legal consequences, you may want to consult an attorney before signing.
When this Acknowledgement is properly completed and signed, the biological father's name is entered on the birth certificate in place of the name of the husband of the mother and the man becomes the legal father of the child. This acknowledgement has the same effect as a court order establishing paternity and can be used as a basis for entering a child support order.
If either of you is not sure that this man is the biological father of this child, you should not sign the form. You should have a genetic test.
Mothers who are married to someone other than the biological father or were married to someone other than the father when the child was conceived, or have been divorced for less than three hundred days must have the agreement of their husband/ex-husband to execute this affidavit. Further, the use of this affidavit is limited to cases where the husband and the mother lived separate and apart continuously for a minimum of one hundred and eighty days prior to the conception of the child and have not reconciled since the beginning of the one hundred eighty-day period. If the agreement of the husband cannot be obtained or if the couple cannot meet the statutory requirements, this affidavit cannot be used. In order for the biological father's name to be added to the birth certificate, a court must establish paternity in accordance with R.S.40:34B.(1)(a)(vii)
RIGHTS AND RESPONSIBLITIES OF A PARENT
•Either party has the right to request a genetic test to determine if the alleged father is the biological father of the child.
•The alleged father has the right to consult an attorney before signing an acknowledgement of paternity.
•If the alleged father does not acknowledge the child, the mother has the right to file a paternity suit to establish paternity. After the alleged father signs an acknowledgement of paternity, he has the right to pursue visitation with the child and the
•right to petition for custody.
•Once an acknowledgement of paternity is signed, the father may be obligated to provide child support for the child.
Once an acknowledgement of paternity is signed, the child will have inheritance rights and any rights afforded children born
•in wedlock.
A party who executed a notarial act of acknowledgement may rescind the act, without cause, before the earlier of the
•following:
-Sixty days after the signing of the act, in a court hearing for the limited purpose of rescinding the acknowledgment.
-A court hearing relating to the child, including a child support proceeding, in which the father is involved.
Thereafter, the acknowledgement of paternity may be voided only upon proof, by clear and convincing evidence, that such act was induced by fraud, duress, or material mistake of fact, or that the father is not the biological father.
BENEFITS FOR YOUR CHILD
Every child has the right to know his or her mother and father and benefit from a relationship with both parents.
Both of your names will appear on the child's birth certificate.
It will be easier for your child to learn medical histories of both parents and to benefit from health care coverage available to you.
It will be easier for your child to receive benefits such as dependent or survivor's benefits from the Veteran's Administration or from the Social Security Administration as well as share any estate should you die.
To indicate that you have read and understood this notice of alternatives, rights and responsibilities, please initial below. If you require further assistance you may call us at (504) 593 - 5100.
Mother’s Initials ________________________
Father’s Initials ________________________
VRR-44 3-P (05/10)
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