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In the state of Arizona, establishing paternity for a child born out of wedlock is a necessary step for acknowledging a legal relationship between a father and his child. The Arizona Department of Economic Security's Division of Child Support Services facilitates this process through the “Acknowledgment of Paternity” form, coded as CS-127 (11-17). This document is essential for children whose parents were not married at the time of the child’s birth or during the ten months immediately before the birth unless a Waiver of Paternity Affidavit is provided. The completion of this form requires careful attention to detail, including using black ink and making no alterations once information is filled in, to avoid any invalidation of the acknowledgment. Each section of the form must be filled out completely, covering the child’s information, mother’s and father's details, and it necessitates signatures from both parents either in front of a witness or a notary public. This form is paramount not only for the legal identification of both parents but also for the child’s right to know and benefit from a relationship with both parents. It opens doors to financial support, understanding of medical history, and eligibility for benefits from both parents. The filing process underscores the state’s dedication to children’s welfare and parents' accountability, ensuring that all necessary steps are taken for the formal acknowledgment of paternity without coercion or duress.

Arizona Paternity Preview

CS-127 (11-17)

GO TO FORM

ARIZONA DEPARTMENT OF ECONOMIC SECURITY

Division of Child Support Services

ACKNOWLEDGMENT OF PATERNITY

En Español

READ ALL INSTRUCTIONS CAREFULLY AND REMOVE THIS PAGE BEFORE COMPLETION

The purpose of this form is to acknowledge paternity for a child born out of wedlock.

This Acknowledgment of Paternity IS NOT applicable if the mother of the child was married at the time of birth or was married at any time in the ten months immediately preceding such birth pursuant to A.R.S. § 25-814, unless accompanied by a Waiver of Paternity Affidavit.

COMPLETION

•Read the “Acknowledgment of Paternity” (CS-127) and the Notice of Alternatives, The legal Consequences and the Rights and Responsibilities.

•Only use BLACK INK. Colored inks ARE NOT ACCEPTABLE. Type or print all required information except where sig- natures are required. The Spanish translation on the last page is for reference only. Please complete the English side.

•DO NOT MAKE CORRECTIONS ON THE FORM. Forms with crossouts, erasures, alterations, etc., will invalidate the Acknowledgment. DO NOT SUBMIT AN ACKNOWLEDGMENT CONTAINING SUCH CHANGES. If you make a mistake, ask for a new form and begin again.

•Fill in every blank or box on the form. Incomplete or incorrect information may cause delays in the filing of the

Acknowledgment.

•In cases of multiple births, a separate Acknowledgment for each child must be completed.

•The Acknowledgment must be signed in the presence of a Witness or Notary Public. Each parent must sign their name on all copies of the form and each signature must be witnessed or notarized. Each parent must show the

Witness or Notary appropriate, valid identification. The parents should use their legal name only. Nicknames, short- ened name, etc., SHOULD NOT be used. Your Legal Name is the one that appears on your birth certificate, or other official documents.

•If both parents cannot sign the Acknowledgment at the same time, use a separate Acknowledgment. When signing separate Acknowledgments the child’s information should be identical on each form. All blanks must be completed and both Acknowledgments submitted together.

•If you are changing the child’s name, after 3 months of age only the last name of the child can be changed using this form. Any other changes must be requested through the Office of Vital Records.

•If completing this Acknowledgment away from the hospital, remember to sign in the presence of a Notary Public or qualified Witness. A qualified Witness must be at least 18 years old and not related to either parent by blood or marriage. Notary Publics are listed in the telephone directory. RETURN ALL PAGES (excluding completion instruc- tions) OF THE ACKNOWLEDGMENT. Mail the entire document to:

DCSS Hospital Paternity Program – HPP

PO BOX 64533

Phoenix, AZ 85082

•If you require a copy of the birth certificate, mail your application monies, along with the birth certificate application, to the address listed on the birth certificate application. DO NOT mail any monies to the Hospital Paternity Program.

DEFINITIONS

DES - Department of Economic Security

DHS - Department of Health Services

DCSS - Division of Child Support Services

HOW WILL YOUR CHILD BENEFIT IF YOU SIGN THIS FORM?

•Every child has the right to know his or her mother and father and benefit from a relationship with both parents.

•Your child will have two legal parents.

•Your child has a right to financial support from both parents.

•It will be easier for your child to learn the medical histories of both parents and to benefit from health care coverage available to you.

•It will be easier for your child to inherit through you and receive benefits such as dependent or survivor’s benefits from Veterans Affairs or the Social Security Administration

Equal Opportunity Employer/Program • Under Titles VI and VII of the Civil Rights Act of 1964 (Title VI & VII), and the Americans with Disabilities Act of 1990 (ADA), Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and Title II of the Genetic Information Nondiscrimination Act (GINA) of 2008; the Department prohibits discrimination in admissions, programs, services, activities, or employment based on race, color, religion, sex, national origin, age, dis- ability, genetics and retaliation. To request this document in alternative format or for further information about this policy, contact 602-252-4045; TTY/TDD Services: 7-1-1. • Free language assistance for DES services is available upon request. Ayuda gratuita con traducciones relacionadas con los servicios del DES esta disponible a solicitud del cliente.

CS-127 (11-17) Page 2

 

 

ARIZONA DEPARTMENT OF ECONOMIC SECURITY

 

 

NO.

 

Clear the Form

 

 

 

 

 

 

 

 

 

 

 

 

 

ACKNOWLEDGMENT OF PATERNITY

 

 

 

 

 

 

 

 

Formulario en Español

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLEASE

PRINT CLEARLY. Complete in BLACK INK. DO NOT ALTER, LEGAL DOCUMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHILD’S INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

CHILD’S NAME (First, Middle, Last, Suffix) AS IT APPEARS ON THE BIRTH CERTIFICATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BIRTHDATE (MM/DD/YY)

 

 

 

 

 

 

 

 

MALE

FEMALE PLACE OF BIRTH

CITY

 

 

 

 

 

 

 

 

 

 

 

COUNTY

 

 

 

 

 

 

 

STATE

 

HOSPITAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOW YOU WANT THE CHILD’S NAME TO APPEAR ON THE BIRTH CERTIFICATE

 

 

 

 

IF THE CHILD’S NAME HAS NOT CHANGED, PLEASE PRINT THE CHILD’S NAME AS IT APPEARS ON THE ORIGINAL BIRTH CERTIFICATE

 

FIRST

 

 

MIDDLE

 

 

 

 

LAST

 

 

 

 

 

 

 

SUFFIX (Jr., II)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MOTHER’S INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRST NAME

 

MIDDLE NAME

 

 

 

LAST NAME

 

 

 

 

 

MAIDEN NAME

 

 

BIRTHDATE (MM/DD/YYYY)

 

 

 

 

 

SOC. SEC. NO.

 

 

 

 

 

 

 

 

 

 

 

AREA CODE AND PHONE NO.

 

 

 

 

 

PLACE OF BIRTH (City, State)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COUNTRY OF BIRTH

 

 

 

 

 

 

 

 

 

 

ADDRESS: (Street, Apt. No., City, State, ZIP)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER

 

 

 

 

 

 

 

 

 

 

 

OCCUPATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FATHER’S INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRST NAME

 

 

 

 

 

 

 

 

MIDDLE NAME

 

 

 

 

 

 

 

 

 

 

 

 

LAST NAME

 

 

 

 

 

BIRTHDATE (MM/DD/YYYY)

 

 

 

 

 

SOC. SEC. NO.

 

 

 

 

 

 

 

 

 

 

 

AREA CODE AND PHONE NO.

 

 

 

 

 

PLACE OF BIRTH (City, State)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COUNTRY OF BIRTH

 

 

 

 

 

 

 

 

 

 

ADDRESS: (Street, Apt. No., City, State, ZIP)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER

 

 

 

 

 

 

 

 

 

 

 

OCCUPATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The mother was legally married at the time of conception and/or birth of the child.

 

A Waiver of Paternity Affidavit completed by

 

 

A court order or decree of dissolution which rebuts paternity is attached.

the present/former husband is attached.

 

This Acknowledgment is being signed voluntarily with no threat or harm or duress. I have received written and oral notice and have read the NOTICE OF ALTERNATIVES, THE LEGAL CONSEQUENCES AND RIGHTS AND RESPONSIBILITIES. I understand my alternatives, the legal consequences and the rights and responsibilities. I swear and affirm under penalty of perjury pursuant to A.R.S. §13-2702 that this application and any accompanying documents have been examined by me and to the best of my knowledge and belief are true and correct.

SIGNATURE OF MOTHER (Sign only in presence of Witness)

 

DATE (MM/DD/YY

 

SIGNATURE OF FATHER (Sign only in presence of Witness)

 

DATE (MM/DD/YY)

 

SIGNATURE OF WITNESS (TO BE COMPLETED BY THE [Check one]:

HOSPITAL

GOVERNMENT AGENCY

OTHER)

SIGNATURE OF WITNESS (TO BE COMPLETED BY THE [Check one]:

HOSPITAL

GOVERNMENT AGENCY

OTHER)

WITNESS MUST BE AT LEAST 18 YEARS OF AGE AND NOT RELATED BY BLOOD OR MARRIAGE.

PRINTED NAME OF WITNESS

 

 

 

 

PRINTED NAME OF WITNESS

 

 

ADDRESS

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

-------------------------------------------------------------------

 

 

 

 

 

 

NOTARY SECTION ------------------------------------------------------------------

 

 

 

 

 

 

 

 

 

 

 

TO BE COMPLETED BY A NOTARY PUBLIC ONLY IF NOT WITNESSED ABOVE

 

 

State of Arizona, County of

 

 

 

 

 

State of Arizona, County of

 

 

 

Subscribed and sworn or affirmed before me

 

 

Subscribed and sworn or affirmed before me

 

 

this

 

day of

 

 

,

 

 

this

 

day of

 

,

 

NOTARY PUBLIC

NOTARY PUBLIC

 

 

 

 

 

 

 

 

PLACE NOTARY SEAL HERE

 

 

 

PLACE NOTARY SEAL HERE

My Commission expires

 

My Commission expires

 

 

 

 

 

 

 

 

 

Check this box if form completed at the hospital.

 

Paternity Date

 

 

 

 

 

ALL COPIES OF THIS DOCUMENT MUST HAVE ORIGINAL SIGNATURES

*B*

 

 

 

For Office Use Only

THIS ACKNOWLEDGMENT IS BEING SIGNED VOLUNTARILY WITH NO THREAT OR HARM OR DURESS

 

 

 

 

 

 

 

 

 

 

 

CS-127 (11-17) Page 3

NOTICE OF ALTERNATIVES, THE LEGAL CONSEQUENCES

AND RIGHTS AND RESPONSIBILITIES

PLEASE READ THIS INFORMATION CAREFULLY BEFORE YOU SIGN THE FORM The purpose of this form is to acknowledge paternity for a child born out of wedlock.

We, the natural mother and natural father, declare that the information provided is true and correct. We acknowledge that the father named is the only possible father of the child named.

If the mother was married at any time in the ten months immediately preceding the birth or the child is born within ten months after the marriage is terminated by death, annulment, declaration of invalidity or dissolution of marriage or after the court enters a decree of legal separation, a Waiver of Paternity Affidavit must accompany this document pursuant to A.R.S. § 25-814.

I understand that if the current/former husband’s location is unknown to the mother, the mother will be required to apply for IV-D Services and The Division of Child Support Services will attempt to locate the current/former husband.

I understand that by signing this acknowledgment we are giving up our right to a court hearing to determine paternity as well as the right to have genetic testing done to determine the parentage of this child.

I further understand we may have a right to rescind or challenge this acknowledgment as outlined in A.R.S. § 25-812. I understand the signing of this acknowledgment will result in the legal determination of paternity.

I understand that upon the determination of paternity, both parents have a legal obligation to support their child pursuant to A.R.S. § 25-501 as well as other duties imposed by Arizona law.

I understand this paternity determination is not a custody order but provides a basis for determining issues related to cus- tody and visitation and affords the parents all rights and responsibilities provided by Arizona law.

I understand that either parent has a right to cancel the Acknowledgment of Paternity by completing an Affidavit of Paterni- ty Rescission within 60 days from the date of the last witnessed/notarized signature on the Acknowledgment and sending it to the Hospital Paternity Program pursuant to A.R.S. § 25-812. I have read the information provided and received oral notification of our rights and responsibilities by either speaking to staff, viewing a paternity video or phoning 1-800-485- 6908.

A voluntary Acknowledgment of Paternity filed with The Department of Economic Security or The Department of Health Services has the same force and effect as a Superior Court judgment pursuant to A.R.S. § 25-812.

I further declare this statement to be made for recording with the Clerk of the Superior Court, the Department of Economic Security or the Department of Health Services pursuant to A.R.S. § 25-812 and hereby consent and request that the birth certificate be amended to show the father’s name and to show the child’s name as requested on the front of the Acknowl- edgment of Paternity. Please note: Any questions regarding name changes should be directed to the Arizona Department of Health Services, Office of Vital Records at (602) 364-1300.

I understand that if it is deemed appropriate by DES, this acknowledgment may be used to obtain a paternity order in any Arizona county having venue.

I understand that I am required to provide my Social Security Number pursuant to 42 USC § 652(a)(7) and 666(a)(5)(IV). DES/DCSS will use this information to establish paternity and if appropriate, to establish and enforce a child support order. I swear or affirm under penalty of perjury pursuant to A.R.S. § 13-2702 that this application and/or accompanying docu- ments have been examined by me and to the best of my knowledge and belief are true and correct.

WHAT DOES IT MEAN IF YOU SIGN THIS FORM?

By signing this Acknowledgment of Paternity you are legally establishing your child’s paternity. Paternity means legal fatherhood.

Signing this form is voluntary. You should not sign this form if you have been threatened or coerced.

This Acknowledgment does not automatically give the father visitation or custody rights, but he may use it to ask the Court for them.

Either parent can rescind this form within 60 days of the last signature on the form by signing an Affidavit of Paternity Re- scission (CS-258). To request an Affidavit of Paternity Rescission, contact the Hospital Paternity Program at 1-800-485-6908.

CS-127 (11-17) Page 4

ARIZONA DEPARTMENT OF ECONOMIC SECURITY

Office of Vital Records

ADDITIONAL INFORMATION REGARDING THE FATHER LISTED ON

THE ACKNOWLEDGMENT OF PATERNITY (for birth certificate processing purposes)

The Arizona Department of Health Services’ Office of Vital Records is required to collect and report data to the Department of Health and Human Services’ National Center for Health Statistics (NCHS). Please complete the data below in order to capture this information for statistical purposes. Thank you in advance for completing this information.

CHILD’S NAME (First, Middle, Last, Suffix)

 

 

BIRTHDATE

 

MOTHER’S NAME (Last, First, M.I.)

 

FATHER’S NAME (Last, First, M.I.)

 

FATHER’S EDUCATION (Check One)

What is the highest level of schooling you will have completed at the time of the child’s delivery? Check one of the following boxes that best describes your education. If you are currently enrolled, check the box that indicates the previous grade or highest degree received.

8th grade or less

Associate degree (e.g. AA, AS )

9th – 12th grade, no diploma

Bachelor’s degree (e.g. BA, AB, BS )

High school graduate or GED completed

Master’s degree (e.g. MA, MS MEng, Med, MSW, MBA )

Some college credit, but no degree

Doctorate degree (e.g. PhD, EdD) or

 

Professional degree (e.g. MD, DDS, DVM, LLB, JD )

 

 

 

FATHER’S RACE (Check All That Apply)

White

Black, African American

American Indian or Alaska Native (*see list below) Primary or Enrolled tribe:

Additional Tribe:

Additional Tribe:

Additional Tribe: Asian Indian Chinese Filipino Japanese Korean

Other Asian

Specify:

Specify:

Native Hawaiian

Guamanian or Chamorro

Samoan

Other Pacific Islander

Specify:

Specify:

Other

Specify:

Specify:

Unknown

Refused

Not Obtainable

*Please select the appropriate Arizona tribe(s) the father is affiliated with from the list provided below and print the tribe name in the space(s) provided above. If the father is affiliated with a non-Arizona tribe, please write “other” in the space provided or print the name of the non-Arizona tribe.

Ak Chin Indian Community

Navajo Tribe

 

 

Camp Verde Yavapai Apache

Pascua Yaqui

 

 

Cocopah Tribe

Prescott Yavapai Indian Community Quechan Tribe

 

Colorado River Indian Tribes

Salt River Indian Community (Pima)

 

Fort Mohave Tribe

San Carlos Apache Tribe

 

 

Ft. McDowell Mohave-Apache Community Gila River Indian Community

San Juan Southern Paiute Band

 

(Pima) Havasupai Tribe

Tohono O’Odham Tribe (Papago)

 

Hopi Tribe

Tonto Apache

 

 

Hualapai Tribe

White Mountain Apache Tribe (Fort Apache)

 

Kaibab Band of Paiute Indian

 

 

 

 

 

 

 

FATHER’S HISPANIC ORIGIN (Check One)

 

 

No, not Spanish, Hispanic or Latino

Dominican, Columbian)

 

 

Yes, Mexican, Mexican American, Chicano

Specify:

 

 

 

Yes, Puerto Rican

Specify:

 

 

 

Yes, Cuban

 

 

Unknown

Refused

Not Obtainable

Yes, other Spanish/Hispanic/Latina (e.g. Spaniard, Salvadoran,

 

 

 

 

CS-127 (11-17) Page 5

ARIZONA DEPARTMENT OF ECONOMIC SECURITY

 

Division of Child Support Services (División de Servicio de Sustento para Menores)

 

RECONOCIMIENTO DE PATERNIDAD

LEA DETENIDAMENTE TODAS LAS INSTRUCCIONES Y DESPRENDA ESTA HOJA ANTES DE LLENAR EL FORMULARIO

El propósito de este formulario es reconocer paternidad para un niño nacido a una madre soltera. Conforme a A.R.S. §25-814(b), este Reconocimiento de Paternidad NO ES aplicable si la madre del niño estuvo casada cuando nació el niño o en cualquier momento durante los diez meses inmediatamente anteriores al nacimiento del niño, salvo que cuando esté acompañado por una Renuncia de Afidávit de Paternidad.

PARA LLENAR EL FORMULARIO

•Lea el “Reconocimiento de Paternidad” (CS-127) y el Aviso de Alternativos, “las Consecuencias legales” y “los Derechos y Res- ponsabilidades’

•Use sólo TINTA NEGRA. NO SE ACEPTARÁ tintas en colores. Escriba a máquina o con letra de molde toda la información reque- rida excepto donde haya que firmar. La traducción al español en la última página es sólo para referencia; sírvase llenar el lado en inglés.

•NO HAGA CORRECCIONES EN EL FORMULARIO. Formularios con tachones, borraduras, alteraciones etc. invalidarán el Reco- nocimiento. NO PRESENTE UN RECONOCIMIENTO QUE CONTENGA TALES MODIFICACIONES. Si comete un error, pida otro formulario y empiece de nuevo.

•Llene cada uno de los espacios o cajas del formulario. La información incompleta o incorrecta puede causar demoras en el registro del Reconocimiento.

•En casos de nacimientos múltiples hay que llenar un Reconocimiento individual para cada niño.

•El reconocimiento se habrá de firmar ante un testigo o notario público. La madre y el padre tienen que firmar sus nombres en todas las copias del formulario y cada una de las firmas tiene que ser certificadas ante un testigo o notario público. La madre y el padre tienen que mostrar identificación apropiada y válida al testigo o notario. Ambos padres deberán utilizar solamente sus nombres legales. NO SE PODRÁ utilizar apodos, nombres acortados, etc. Su nombre legal es el que aparece en su certificado de nacimiento u otros documentos oficiales.

•Si ambos padres no pueden firmar el Reconocimiento a la vez, use Reconocimientos separados. Cuando firmen Reconocimientos separados, la información sobre el niño tiene que ser idéntica en ambos formularios. Todos los espacios se tienen que llenar, y presentarse ambos Reconocimientos simultáneamente.

•Si usted va a cambiar el nombre del niño, después de los 3 meses de edad se puede cambiar solamente el apellido del niño usando este formulario. Se debe pedir cualquier otro cambio por la oficina de estadísticas demográficas

•Si llenan este Reconocimiento fuera del hospital, recuerde certificar las firmas ante un notario público o un testigo calificado. Un testigo calificado tiene que tener por lo menos 18 años de edad y no tener parentesco sanguíneo o por matrimonio con ninguno de los padres. Los notarios públicos están listados en el directorio telefónico. DEVUELVA TODAS LAS PÁGINAS DEL RECONOCI- MIENTO (excepto las instrucciones para llenarlo). Envíe el documento completo a:

DCSS Hospital Paternity Program – HPP

PO BOX 64533

Phoenix, AZ 85082

•Si requiere una copia del certificado de nacimiento, envíe su dinero de solicitud, también con la solicitud por certificado de naci- miento, a la dirección listada en la solicitud por certificado de nacimiento. NO envíe ningún dinero al Programa de Paternidad en los Hospitales.

DEFINICIONES

DES - Departamento de Seguridad Económica

DHS - Departamento de Servicios de Salud

DCSS - División de Servicio de Sustento para Menores

¿CÓMO SE APROVECHARÁ SU HIJO SI USTED FIRME ESTE FORMULARIO?

•Cada niño tiene derecho de conocer a su madre y padre y sacar provecho de una relación con ambos padres.

•Su hijo tendrá tanto una madre como un padre legal.

•Su hijo tiene derecho de asistencia financiera de ambos padres.

•Será más fácil para su hijo obtener las historias médicas de ambos padres y aprovecharse la cobertura médica disponible a usted.

•Será más fácil para su hijo heredar a través de usted y recibir beneficios tales como beneficios para dependientes o sobrevivientes de la Administración de Veteranos o la Administración de Seguro Social.

Programa y Empleador con Igualdad de Oportunidades • Bajo los Títulos VI y VII de la Ley de los Derechos Civiles de 1964 (Títulos VI y VII) y la Ley de Estadounidenses con Discapacidades de 1990 (ADA por sus siglas en inglés), Sección 504 de la Ley de Rehabilita- ción de 1973, Ley contra la Discriminación por Edad de 1975 y el Título II de la Ley contra la Discriminación por Información Genética (GINA por sus siglas en inglés) de 2008; el Departamento prohíbe la discriminación en la admisión, programas, servicios, actividades o empleo basado en raza, color, religión, sexo, origen, edad, discapacidad, genética y represalias. Para obtener este documento en otro formato u obtener información adicional sobre esta política, llame al 602-252-4045; Servicios de TTY/TDD: 7-1-1. • Ayuda gratuita con traducciones relacionadas a los servicios del DES está disponible a solicitud del cliente. Free language assistance for DES services is available upon request

CS-127 (11-17) Page 6

Form in English

ARIZONA DEPARTMENT OF ECONOMIC SECURITY

NÚM. Remueva el Formulario

RECONOCIMIENTO DE PATERNIDAD

FAVOR DE ESCRIBIR CLARAMENTE. Llene con TINTA NEGRA. NO ALTERE ESTE DOCUMENTO LEGAL

INFORMACIÓN DEL NIÑO

NOMBRE DEL NIÑO (Primer nombre, segundo, apellido, sufijo) COMO APARECE EN EL CERTIFICADO DE NACIMIENTO

FECHA DE NACIMIENTO (Mes/día/año)

 

MALE

FEMALE LUGAR DE NACIMIENTO CIUDAD

 

CONDADO

 

ESTADO

 

 

HOSPITAL

 

CÓMO DESEA QUE APAREZCA EL NOMBRE DEL NIÑO EN EL CERTIFICADO DE NACIMIENTO

SI EL NOMBRE DEL NIÑO NO HA CAMBIADO, ESCRIBA EL NOMBRE TAL COMO APARECE EN EL CERTIFICADO DE NACIMIENTO ORIGINAL

PRIMER NOMBRE

 

 

SEGUNDO NOMBRE

 

 

 

 

APELLIDO

 

 

 

 

 

 

SUFIJO (Jr., II)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMACIÓN DE LA MADRE

PRIMER NOMBRE

 

 

SEGUNDO NOMBRE

 

 

 

APELLIDO

 

 

 

 

 

 

 

NOMBRE DE SOLTERA

 

FECHA DE NACIMIENTO (Mes/día/año)

 

 

 

NÚM. DE SEGURO SOCIAL

 

 

 

CÓDIGO DE ÁREA Y TELÉFONO

 

LUGAR DE NACIMIENTO (Ciudad, estado)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAÍS DE NACIMIENTO

 

DOMICILIO (Calle, núm. de apartamento, ciudad, estado, código postal ZIP)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLEADOR

 

 

 

 

 

 

 

 

 

OCUPACIÓN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMACIÓN DEL PADRE

PRIMER NOMBRE

 

 

 

 

 

SEGUNDO NOMBRE

 

 

 

 

 

 

 

 

 

 

 

 

APELLIDO

 

FECHA DE NACIMIENTO (Mes/día/año)

 

 

 

NÚM. DE SEGURO SOCIAL

 

 

 

CÓDIGO DE ÁREA Y TELÉFONO

 

LUGAR DE NACIMIENTO (Ciudad, estado)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAÍS DE NACIMIENTO

 

DOMICILIO (Calle, núm. de apartamento, ciudad, estado, código postal ZIP)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLEADOR

 

 

 

 

 

 

 

 

 

OCUPACIÓN

 

 

 

 

 

 

 

 

 

 

 

La madre estaba casada legalmente al momento de la concepción/el nacimiento del niño. Adjunto hay una orden del tribunal o decreto de disolución que refuta la paternidad.

Adjunto hay una renuncia de Affidávit de Paternidad llenado por del esposo actual/anterior.

Este Reconocimiento de Paternidad se firma voluntariamente, sin amenaza, ni perjuicio ni por coacción. He recibido aviso escrito y verbal, y he leído el AVISO DE LAS OPCIONES, LAS CONSECUENCIAS LEGALES Y LOS DERECHOS Y RESPONSABILIDADES. Comprendo mis opciones, las consecuencias legales y los derechos y las responsabilidades. Juro y afirmo bajo pena de perjurio conforme a A. .S. §13-2702 que he examinado esta solicitud y todos los documentos adjuntos y que según mi leal entender y saber, son ciertos y correctos.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRMA DE LA MADRE

 

 

 

 

FECHA (Mes/día/año)

FIRMA DEL PADRE

 

 

FECHA (Mes/día/año)

(Firma solamente en presencia de un Testigo)

 

 

(Firma solamente en presencia de un Testigo)

 

 

 

 

 

 

 

NO FIRME AQUÍ

 

 

 

 

 

FIRMA DEL TESTIGO (SERÁ LLENADO POR [Marque uno] :

 

FIRMA DEL TESTIGO (SERÁ LLENADO POR [Marque uno] :

 

HOSPITAL

 

 

GUBERNAMENTAL

 

 

OTRO)

 

HOSPITAL

AGENCIA GUBERNAMENTAL

 

OTRO)

AGENCIAINVALIDO PARA REGISTRO

 

 

 

 

 

 

EL TESTIGO HABRÁ DE TENER POR LO MENOS 18 AÑOS DE EDAD Y NO TENER PARENTESCO SANGUÍNEO NI POR MATRIMONIO.

NOMBRE DEL TESTIGO CON LETRA DE MOLDE

 

 

 

 

 

 

 

NOMBRE DEL TESTIGO CON LETRA DE MOLDE

 

 

 

 

 

DIRECCIÓN

 

 

 

 

 

 

 

 

 

 

 

 

DIRECCIÓN

 

 

 

 

 

 

 

 

 

DIRECCIÓN

 

 

 

 

 

 

 

 

 

 

 

 

DIRECCIÓN

 

 

 

 

 

 

 

 

 

 

-----------------------------------------------------------

 

 

 

 

 

 

 

 

SECCIÓN PARA EL NOTARIO ----------------------------------------------------------

 

 

 

 

 

 

 

 

 

LA LLENARÁ UN NOTARIO PÚBLICO SOLAMENTE EN AUSENCIA DE TESTIGOS ARRIBA

 

 

 

 

 

Estado de Arizona, condado

 

 

 

 

 

 

 

 

 

Estado de Arizona, condado

 

 

 

 

 

 

Subscrito y jurado o afirmado ante mí

 

 

 

 

 

 

 

Subscrito y jurado o afirmado ante mí

 

 

 

 

 

este

 

día de

 

 

 

,

 

 

 

 

 

 

este

 

día de

 

,

 

 

 

 

NOTARIO PÚBLICO

NOTARIO PÚBLICO

 

SELLO DEL NOTARIO AQUÍ

 

SELLO DEL NOTARIO AQUÍ

Mi comisión termina

Mi comisión termina

Marque esta cajita se llenó el formulario en el hospital.

Fecha de paternidad

 

TODAS LAS COPIAS DE ESTE DOCUMENTO DEBEN TENER FIRMAS ORIGINALES.

Sólo para uso de oficina

ESTE DOCUMENTO DE PATERNIDAD SE FIRMA VOLUNTARIAMENTE, SIN AMENAZA, PERJUICION NI COACCIÓN

CS-127 (11-17) Page 7

AVISO DE LAS OPCIONES, LAS CONSECUENCIAS LEGALES,

LOS DERECHOS Y LAS RESPONSABILIDADES

LEA ESTA INFORMACIÓN DETENIDAMENTE ANTES DE FIRMAR EL FORMULARIO

El propósito de este formulario es reconocer paternidad para un niño nacido a una madre soltera.

Nosotros, la madre biológica y el padre biológico, declaramos que la información provista es cierta y correcta. Reconoce- mos que el padre nombrado es el único padre posible del niño nombrado.

Si la madre del niño estuvo casada en cualquier momento durante los 10 meses inmediatamente anteriores al nacimiento del niño o si el nacimiento del niño ocurrió dentro de 10 meses de haber terminado el matrimonio por causa de muerte, anulación, declaración de invalidez o disolución del matrimonio, o después que el tribunal haya registrado un decreto de separación legal. Según A.R.S. § 25-814, una Renuncia de Affidávit de Paternidad debe acompañar este documento.

Entiendo que si la madre no sabe el paradero del esposo actual/anterior, la madre tendrá que solicitar servicios de IV-D y la División de Servicio de Sustento para Menores intentará localizar al esposo actual/anterior.

Entiendo que al firmar este reconocimiento cedemos nuestro derecho de una audiencia para determinar paternidad ante un tribunal, así como nuestro derecho de pruebas genéticas para determinar la paternidad para este niño.

Entiendo además que quizá tengamos derecho de rescindir o recusar este reconocimiento conforme a A.R.S. § 25-812. Entiendo que el firmar este reconocimiento resultará en la determinación legal de la paternidad.

Entiendo que al determinar la paternidad, ambos padres tienen una obligación legal de mantener a su hijo conforme a A.R.S. § 25-501, así como otras obligaciones impuestas por la ley de Arizona.

Entiendo que esta determinación de paternidad no es una orden de custodia pero sirve como base para determinar asuntos relacionados con la custodia y las visitas, y proporciona a los padres todos los derechos y responsabilidades provistos por la ley de Arizona.

Entiendo que cualquiera de los padres tiene derecho de cancelar el Reconocimiento de Paternidad llenando un Afidávit de Rescisión de Paternidad dentro de 60 días desde la fecha de la última firma preparada ante un testigo/notario público en el Reconocimiento, y enviándolo al Programa de Paternidad en Hospitales conforme a A.R.S. § 25-812. He leído la informa- ción provista y recibido aviso verbal de nuestros derechos y responsabilidades bien por hablar con el personal, o por ver un video sobre la paternidad, o por llamar aI 1-800-485-6908.

Un Reconocimiento de Paternidad voluntario registrado con el Departamento de Seguridad Económica o el Depar- tamento de Servicios de Salud tiene el mismo peso y efecto como un fallo del Tribunal Superior conforme a A.R.S. § 25-812.

Declaro además que esta declaración sea hecha para ser registrada con el Secretario del Tribunal Superior, el Departa- mento de Seguridad Económica o el Departamento de Servicios de Salud conforme a A.R.S. § 25-812, y por este acto con- siento y pido que se enmiende el certificado de nacimiento para reflejar el nombre del padre y el nombre del niño tal como sea pedido en el frente del Reconocimiento de Paternidad. Note por favor: Cualquier pregunta relacionada con cambiar el nombre se deberá dirigir al Departamento de Servicios de Salud, Oficina de Estadísticas Demográficas.

Entiendo que si DES lo estima apropiado, este reconocimiento se podrá utilizar para obtener una orden de paternidad en cualquier condado con jurisdicción en Arizona.

Entiendo que conforme a 42 USC § 652(a) (7) y 666(a) (5) (IV) debo proporcionar mi número de Seguro Social. DES/ DCSS utilizará esta información para establecer paternidad y, si es apropiado, para establecer y hacer cumplir una orden de alimentos para menores.

Juro o afirmo bajo pena de perjurio conforme a A.R.S. § 13-2702 que he examinado esta solicitud y/o los documentos ad- juntos y que según mi mejor saber y entender son ciertos y correctos.

¿QUÉ SIGNIFICA SI YO FIRME ESTE FORMULARIO?

Mediante su firma en este Reconocimiento de Paternidad usted legalmente establece la paternidad de su niño. La pater- nidad significa que usted es el padre legal del niño.

El firmar este formulario es voluntario. Usted no debe firmar este formulario si le han amenazado o coaccionado.

Este Reconocimiento no le otorga automáticamente al padre los derechos de custodia o visitas, pero él puede utilizarlo para pedir esos derechos en el tribunal.

Cualquiera de los padres puede rescindir este formulario dentro de 60 días de la última firma en el formulario firmando un Afidávit de Rescisión de Paternidad (CS-258). Comuníquese con el Programa de Paternidad en Hospitales al 1-800-485- 6908 si desea un Afidávit de Rescisión de Paternidad.

CS-127 (11-17) Page 8

ARIZONA DEPARTMENT OF ECONOMIC SECURITY

(Departamento de Sanidad de Arizona)

Office of Vital Records (Oficina de Registro Civil)

INFORMACIÓN ADICIONAL SOBRE EL PADRE QUE FIGURA EN EL

RECONOCIMIENTO DE PATERNIDAD (para el trámite de partida de nacimiento)

La Oficina de Registro Civil del Departamento de Sanidad de Arizona tiene la obligación de recabar y transmitir la información al Centro Nacional de Estadísticas de Sanidad del Departamento de Sanidad y Servicios Humanitarios (NCHS por sus siglas en inglés). Por favor proporcione los datos que se solicitan a continuación, los que se recaban con fines estadísticos. Gracias de antemano por proporcionar la información.

NOMBRE DEL NIÑO (apellido, nombre, sufijo)

 

 

 

FECHA DE NACIMIENTO

 

NOMBRE DE LA MADRE

NOMBRE DEL PADRE

 

(apellido, nombre, inicial del segundo nombre)

 

 

(apellido, nombre, inicial del segundo nombre)

EDUCACIÓN DEL PADRE (marque una)

¿Cuál es el nivel más alto de educación que usted obtuvo al momento del nacimiento del niño? Marque una de las casillas que mejor des- criba su educación. Si en la actualidad usted está matriculado, marque la casilla que indica el grado anterior o el título más alto obtenido.

8.ᵃᵛᵒ grado o menos

Diploma por dos años de estudios superiores (ej. AA, AS)

9.ᶰᵒ – 12.ᵃᵛᵒ grado, no diploma

Licenciatura (ej. BA, AB, BS )

Graduado de bachillerato o certificado de GED

Maestría (ej. MA, MS MEng, Med, MSW, MBA)

Algunos créditos de educación superior, pero sin título

Doctorado (ej. PhD, EdD) o Profesional (ej. MD, DDS, DVM, LLB, JD)

RAZA DEL PADRE (marque todo lo que corresponda)

Blanco

Negro, afroestadounidense

Amerindio o nativo de Alaska (*vea la lista a continuación) Tribu principal o inscrita:

Tribu adicional: Tribu adicional: Tribu adicional:

Indio asiático

Chino

Filipino

Japonés

Coreano

Otros asiáticos

Especifique:

Especifique:

Hawaiano

Guameño o chamorro

Samoano

Otros isleños de la Polinesia

Especifique:

Especifique:

Otros

Especifique:

Especifique:

Desconocido

Rehúsa

No se puede obtener

*Por favor, seleccione de la siguiente lista la(s) tribu(s) apropiada(s) de Arizona con la(s) que el padre tiene afiliación y escriba el nom- bre de la tribu en el espacio que se da a continuación. Si el padre tiene afiliación a una tribu que no es de Arizona, por favor escriba “otros” en el espacio correspondiente o el nombre de la tribu que no pertenece a Arizona.

Comunidad Indígena Ak Chin

Tribu Navajo

 

 

Camp Verde Yavapai Apache

Pascua Yaqui

 

 

Tribu Cocopah

Comunidad Indígena Prescott Yavapai

 

Tribus Indígenas de Colorado River

Tribu Quechan

 

 

Tribu Fort Mohave

Comunidad Indígena Salt River (Pima)

 

Comunidad Mohave-Apache Ft. McDowell

Tribu San Carlos Apache

 

 

Comunidad Indígena Gila River (Pima)

San Juan Southern Paiute Band

 

Tribu Havasupai

Tribu Tohono O’Odham (Papago)

 

Tribu Hopi

Tonto Apache

 

 

Tribu Hualapai

Tribu White Mountain Apache (Fort Apache)

Kaibab Band de Indígenas Paiute

 

 

 

 

 

 

 

ORIGEN HISPÁNICO DEL PADRE (marque uno)

 

 

No, no soy español, hispánico o latino

dominicano, colombiano)

 

 

Sí, soy mejicano, mejicano americano, chicano

Especifique:

 

 

 

Sí, soy portorriqueño

Especifique:

 

 

 

Sí, soy cubano

 

 

Desconocido

Rehúsa

No se puede obtener

Sí, soy otro español/hispánico/latino (ej. español, salvadoreño,

 

 

 

 
⇓ Arizona Paternity PDF Form

File Properties

Fact Detail
Form Identification The form is identified as CS-127 (11-17) and is issued by the Arizona Department of Economic Security, Division of Child Support Services.
Purpose Its primary purpose is to establish paternity for a child born out of wedlock.
Exclusion Criteria It is not applicable if the child's mother was married at the time of the child's birth or within ten months preceding the birth, according to A.R.S. § 25-814, unless accompanied by a Waiver of Paternity Affidavit.
Submission Requirements Forms must be completed using black ink only, without corrections such as cross-outs or erasures, and all information must be provided accurately to avoid delays.
Legal Consequences Signing the Acknowledgment of Paternity has significant legal consequences, including the establishment of legal fatherhood, the child's right to support from both parents, and potential impacts on inheritance and health care coverage.
Governing Law The form is governed by Arizona Revised Statutes §§ 25-814 and 25-812, outlining the laws related to paternity acknowledgments.

Instructions on Utilizing Arizona Paternity

When preparing to establish paternity for a child born out of wedlock in Arizona, the Acknowledgment of Paternity form (CS-127) is a key legal document to be completed. This act, while voluntary, holds significant legal implications including the establishment of legal parentage, rights to child support, and potential inheritance. Prior to completion, it’s crucial to attentively peruse all provided instructions and pertinent notices detailing the rights, responsibilities, and legal outcomes of this acknowledgment. The process requires diligence in filling out the form to ensure accuracy and legality, avoiding any changes or errors that could invalidate the acknowledgment.

  1. Ensure you have the English side of the CS-127 form ready for completion.
  2. Using only black ink, begin to fill out the form. Colored inks are not accepted.
  3. Enter the child's information as it appears on the birth certificate. If you wish to change how the child's name appears, provide the desired name in the specified section.
  4. Fill in the mother's information including her full legal name, maiden name (if applicable), social security number, phone number, birth details, address, employer, and occupation.
  5. Proceed to complete the father's section with the same level of detail as required for the mother’s information.
  6. Indicate if the mother was married at the time of the child's conception or birth, attaching necessary documents if applicable.
  7. Acknowledge the voluntary nature of this form by checking the appropriate box and confirm receipt and understanding of the legal consequences and rights and responsibilities associated with signing the form.
  8. Both parents must sign the form in the presence of a Witness or Notary Public. Signatures must be original on all copies of the document.
  9. Complete the witness information. Remember, a witness must be at least 18 years old and not related by blood or marriage.
  10. If notarization is not performed by a qualified witness, have the form notarized by a Notary Public.
  11. If applicable, fill out the additional information required by the Arizona Department of Health Services’ Office of Vital Records on the last page for birth certificate processing purposes.
  12. Review the form carefully to ensure all information is accurate and no sections have been altered.
  13. Mail the completed form, excluding the instructional page, to: DCSS Hospital Paternity Program – HPP, PO BOX 64533, Phoenix, AZ 85082.
  14. If a copy of the birth certificate is needed, send the application fee along with the birth certificate application to the address listed on the birth certificate application form, not to the Hospital Paternity Program.

Upon submitting the Acknowledgment of Paternity to the Arizona Department of Economic Security, the legal establishment of paternity is set into motion, facilitating the legal recognition of the father. This grants the child rights to financial support, inheritance, and medical histories from both parents, reaffirming the importance of completing and submitting this form with accuracy and responsibility.

Listed Questions and Answers

What is the purpose of the Arizona Acknowledgment of Paternity form (CS-127)?

The purpose of the Arizona Acknowledgment of Paternity form is to establish the legal paternity for a child born to unwed parents. By completing this form, the child can have a legal relationship with both parents, which supports rights such as financial support from both parents and access to medical history from both sides.

Who should not use the Acknowledgment of Paternity form?

This form should not be used if the mother was married at the time of the child's birth or at any time during the ten months preceding the birth. In such cases, a Waiver of Paternity Affidavit is required unless a court order or legal document establishes paternity differently.

How should the Acknowledgment of Paternity form be completed?

The form must be filled out using black ink only. Both parents should use their legal names as appeared on their birth certificates or official documents. Corrections, such as crossouts or alterations, will invalidate the Acknowledgment. The form must be signed in the presence of a Witness or Notary Public, and each signature must be witnessed or notarized.

What if both parents cannot sign the form at the same time?

If both parents are not available to sign the form together, separate Acknowledgments must be used. However, ensure that the child’s information on both forms is identical, and both Acknowledgments are submitted together.

Can the child's name be changed using the Acknowledgment of Paternity form?

Yes, but only the child's last name can be changed using this form, and only if the child is older than 3 months. For any other name changes or changes for a child younger than 3 months, you must contact the Office of Vital Records.

What are the benefits of signing the Acknowledgment of Paternity form?

Signing the form provides numerous benefits for the child, including establishing two legal parents, securing financial support from both parents, making it easier to obtain medical histories from both sides, and assisting in inheritance and eligibility for benefits.

How is the signed Acknowledgment of Paternity form submitted?

After completion, the entire document (excluding the instruction sheet) should be mailed to the DCSS Hospital Paternity Program at the address provided in the form's instructions.

Can the Acknowledgment of Paternity be rescinded or canceled?

Yes, either parent can cancel the Acknowledgment of Paternity by completing an Affidavit of Paternity Rescission and sending it to the Hospital Paternity Program within 60 days from the date of the last witnessed/notarized signature on the Acknowledgment.

What happens after the Acknowledgment of Paternity form is signed?

Signing the form creates a legal determination of paternity. It gives the child the right to financial support from both parents and confers other legal duties and responsibilities according to Arizona law. However, it does not automatically grant custody or visitation rights; these would need to be determined through further legal action.

Common mistakes

Filling out the Arizona Acknowledgment of Paternity form is a crucial step in ensuring the legal recognition of a father's relationship to a child. However, mistakes in this process can lead to delays, additional legal processes, or the invalidation of the form. Here are nine common mistakes people often make:

  1. Using colored ink: The form requires that all entries be made in black ink only. Using any other color can result in the form being rejected.
  2. Corrections on the form: Any crossouts, erasures, or alterations can invalidate the document. If a mistake is made, one must start over with a new form instead of trying to correct it.
  3. Incomplete information: Every blank or box on the form needs to be filled in. Leaving sections incomplete can cause delays or require the form to be resubmitted.
  4. Mistakes with legal names: Parents often use nicknames or shortened versions of their legal names. However, the form requires the use of the legal name as it appears on official documents like birth certificates.
  5. Not using a separate form for multiple births: In the case of multiple births (twins, triplets, etc.), a separate Acknowledgment form must be completed for each child to individually acknowledge paternity.
  6. Signing without a witness or notary: The Acknowledgment must be signed in the presence of a qualified witness or notary public. Failing to do so can make the form legally void.
  7. Not providing valid identification to the witness or notary: When signing, each parent must show appropriate, valid identification to the witness or notary public. Failure to do so can invalidate the witness or notarization.
  8. Submitting the form with one parent missing: If both parents are not available to sign the Acknowledgment at the same time, separate forms should be used, ensuring the child’s information matches on both. However, not submitting both Acknowledgments together can lead to processing issues.
  9. Not returning all pages: All pages of the Acknowledgment, excluding the instruction sheet, must be returned. Omitting any part of the form can lead to it being considered incomplete.

It's essential for parents to approach completing the Arizona Acknowledgment of Paternity form with care and attention to detail to avoid these common errors. Ensuring accuracy and completeness can greatly simplify the legal establishment of paternity.

Documents used along the form

When completing the Arizona Paternity form, several other documents and forms often play a supporting role, either by providing necessary information or by serving as additional legal steps in establishing paternity, rights, and responsibilities. Understanding these documents will ensure a smoother process in acknowledging paternity and addressing related legal matters.

  • Waiver of Paternity Affidavit - Required if the child's mother was married during the child's conception or birth, this document waives the rights of a presumed father, allowing the biological father to acknowledge paternity.
  • Application for Birth Certificate - After paternity is established, this form is used to apply for or update the child's birth certificate to include the father's name and possibly change the child's last name.
  • Child Support Worksheet - Used to calculate the amount of child support the non-custodial parent is obligated to pay, considering the parents' income, the child's needs, and custody arrangements.
  • Legal Decision-Making (Custody) and Parenting Time Forms - Required when parents seek a court order for custody and visitation rights, outlining the legal decision-making authority and the time a child will spend with each parent.
  • Voluntary Acknowledgment of Paternity Rescission Form (CS-258) - Allows parents to rescind (cancel) the acknowledgment of paternity within 60 days of signing the original document, if needed.
  • Income and Expense Declaration Form - Required for child support proceedings, detailing each parent's financial situation to ensure fair calculation of child support payments.
  • Order of Paternity - A court order that legally establishes paternity when the Acknowledgment of Paternity is signed and properly filed, or through a court proceeding.
  • Child Custody Jurisdiction Affidavit - Affirms the child's residential status and helps determine if Arizona has jurisdiction over custody matters.
  • Genetic Test Order - If paternity is disputed, the court may order genetic testing. This form is used to request or comply with such an order.
  • Child’s Medical History Form - Often used in connection with paternity and custody proceedings to provide a comprehensive health history of the child.

These documents, when used in conjunction with the Arizona Paternity form, help ensure that all legal aspects of paternity, child support, custody, and the child’s welfare are properly addressed. Each form serves a unique purpose, contributing to the establishment of legal fatherhood and the fulfillment of both parents' rights and responsibilities towards their child. It's advised to seek legal guidance when navigating through these processes to ensure compliance with Arizona law and to safeguard the best interests of the child.

Similar forms

The Arizona Paternity form shares similarities with the Birth Certificate Application form. Both documents are essential for registering vital aspects of a child's identity. The Birth Certificate Application, much like the Acknowledgment of Paternity, is filled out soon after a child's birth and is necessary for legal recognition of the child’s identity by the state. They require accurate parental information, ensuring the child's rightful claim to identity, citizenship, and familial relationships.

A Child Support Order form is another document closely related to the Arizona Paternity form. Establishing paternity is a critical step towards securing child support. Both documents contribute to the child's financial wellbeing, with the Paternity form providing the legal basis for a father’s financial responsibilities, and the Child Support Order specifying the details of the financial support agreement.

The Application for Social Security Card shares a purpose with the Paternity form by assisting in establishing a child's formal identity and eligibility for benefits. While the Paternity form acknowledges the father's relationship to the child, the Social Security Card application is crucial for the child to be recognized as a beneficiary for various social services and governmental benefits, including those that may come from the father.

Another related document is the Voluntary Acknowledgment of Parentage. Similar to the Arizona Paternity form, this document is a legal acknowledgment of a parental relationship between a father and his child. Both serve as foundational evidence for the child’s right to benefits from both parents, identity establishment, and are critical in matters of inheritance and legal custody.

The Legal Name Change Form, while used for a different purpose, is related through its use in possibly amending a child’s surname following the signing of the Paternity form. Should the parents decide on a name change that reflects the paternity acknowledgment, this form facilitates that process, directly impacting the child's identity documents.

An adoption consent form bears similarities to the Paternity form in its involvement in legal family structures. While the Paternity form establishes a biological relationship, the consent form for adoption is pivotal in creating a legally recognized parental bond between a child and their adoptive parents, underscoring the commitment to the child's wellbeing and rights.

Marriage License Applications are indirectly connected to the Paternity form by their role in documenting key life events that influence familial and legal relationships. A Marriage License legalizes the relationship between adults, while the Paternity form establishes the legal relationship between a father and his child, both impacting the family’s legal structure.

The Emergency Contact Information Form, often used in schools and medical facilities, is similarly vital for a child's safety and wellbeing. Having the paternity legally acknowledged ensures that a father can be listed as an emergency contact, enabling him to make critical decisions on behalf of his child.

Health Insurance Enrollment forms for children also tie back to the necessity of acknowledging paternity. Establishing paternity can expand a child's access to health benefits, including being added to the father's insurance policy, thus ensuring the child’s health and financial security.

Lastly, the passport application for minors is analogous to the Paternity form as both require verification of parental relationships for processing. Just as paternity needs to be acknowledged for certain legal rights and responsibilities, both parents’ consent or evidence of legal guardianship is typically needed for a child’s passport application, emphasizing the importance of legal documentation in safeguarding a child’s rights to travel and identity.

Dos and Don'ts

When completing the Arizona Acknowledgment of Paternity form, it's important to pay attention to several dos and don’ts to ensure the process goes smoothly and helps establish paternity accurately. Below are critical points to keep in mind:

  • Do read all the instructions carefully before beginning to fill out the form to understand the process and requirements fully.
  • Do use black ink only for completing the form. Colored inks are not acceptable and can lead to the form being rejected.
  • Do not make corrections on the form such as crossouts, erasures, or other alterations, as this will invalidate the Acknowledgment. If a mistake is made, start over with a new form.
  • Do fill in every blank or box on the form. Incomplete or incorrect information could delay the filing process or impact the legal acknowledgment of paternity.
  • Do complete a separate Acknowledgment for each child in cases of multiple births to ensure each child's paternity is properly documented.
  • Do sign the Acknowledgment in the presence of a Witness or Notary Public, and ensure that each parent's signature is witnessed or notarized. Proper identification is required at the time of signing.
  • Do not use nicknames or shortened names. It's crucial to use legal names only, as they appear on official documents like birth certificates.
  • Do mail the entire document, excluding the instruction page, to the specified address once completed to ensure it is processed.
  • Do not mail any application monies to the Hospital Paternity Program. If requiring a copy of the birth certificate, send the necessary fees along with the birth certificate application to the designated address on the birth certificate application form.

Following these guidelines can significantly smooth the process of establishing paternity through the Arizona Department of Economic Security, Division of Child Support Services. It ensures that all legal aspects are correctly adhered to, facilitating the rights and responsibilities of both parents towards their child.

Misconceptions

There are several misconceptions about the Arizona Acknowledgment of Paternity form that can confuse parents. Understanding these can help ensure that the process of acknowledging paternity goes smoothly and without unnecessary complications.

  • It’s only for fathers to fill out: This is a common mistake. Both parents must complete the form, not just the father. The acknowledgment establishes legal paternity and affects both parents, making it necessary for both the mother and father to fill out and sign the form.

  • You can use any ink color: The form specifies that only black ink is acceptable. Using other colors can lead to the acknowledgment being invalid. This requirement ensures that the form is legible and that all copies are consistent in appearance.

  • It automatically grants custody rights: Signing the Acknowledgment of Paternity form does not automatically grant custody rights to the father. While establishing paternity is the first legal step towards seeking custody or visitation rights, further legal action is needed to establish these rights.

  • It can be completed with corrections: The form cannot have any crossouts, erasures, or alterations. If a mistake is made, the parents must request a new form and start over. This rule ensures the integrity and clarity of the legal document.

  • Any witness is acceptable: The witness or notary public must meet specific criteria. They must be at least 18 years old and not related by blood or marriage to either parent. This requirement helps maintain the impartiality of the witness.

  • You can submit incomplete forms: Every blank or box on the form must be completed. Incomplete or incorrect information can cause delays. This comprehensive approach ensures that all necessary details are legally documented from the start.

It's crucial for parents to be fully aware of these details to avoid any issues during the paternity acknowledgment process. Proper completion of the Acknowledgment of Paternity form is a step forward in legally establishing paternity, which has significant implications for both the child's and parents' rights and responsibilities.

Key takeaways

  • Before filling out the Arizona Acknowledgment of Paternity form, it's crucial to read all of the provided instructions carefully to avoid making mistakes that could invalidate the document.

  • Use of black ink is mandatory when completing the form as colored inks will not be accepted.

  • Corrections such as crossouts, erasures, or alterations on the form are not allowed. If an error is made, obtaining a new form and starting over is necessary to maintain the form's validity.

  • Ensuring all blanks and boxes on the form are filled is essential. Incomplete or inaccurate information can lead to delays in processing.

  • When multiple births occur, a separate Acknowledgment form must be completed for each child, underscoring the meticulous attention to detail required during the process.

  • The Acknowledgment must be signed in the presence of a Witness or Notary Public. This step is vital for the form’s legal validity, emphasizing the importance of planning the signing in an appropriate setting.

  • Both parents are required to use their legal names only on the form. Nicknames or shortened names are inappropriate and can lead to the form being questioned or invalidated.

  • In instances where one parent is unavailable to sign, separate Acknowledgments should be used with identical information about the child on both forms. This ensures accuracy and uniformity in the legal acknowledging process.

  • Changes to the child’s name after 3 months of age can only concern the last name when using this form. This highlights the need for timeliness and precision when considering legal name changes through paternity acknowledgment.

  • The completed form should be mailed to the DCSS Hospital Paternity Program excluding the instruction page. Understanding the specific submission protocol is crucial for proper processing.

  • Signing the form voluntarily acknowledges paternity, providing the child with numerous benefits, including financial support from both parents, medical history knowledge, and the possibility of health care benefits.

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