Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Voluntary Request For Order Of Paternity Form. This is a Arizona form and can be use in Coconino Local County.
Tags: Voluntary Request For Order Of Paternity, Arizona Local County, Coconino
(1) Person Filing:
Street Address:
City, State, Zip Code:
Phone Number:
Representing Self
SUPERIOR COURT OF ARIZONA, COUNTY OF COCONINO
(2) Petitioner:
[ ] Mother [ ] Father
Maiden Name:
Birthdate:
Birthplace (City, State, Country):
Case Number: DO
VOLUNTARY REQUEST FOR ORDER OF
PATERNITY
A.R.S. 25-812
(3) Respondent:
[ ] Mother [ ] Father
Maiden Name:
Birthdate:
Birthplace (City, State, Country):
The mother named above is the natural mother of the following child(ren). She was unmarried when
each child was born and for the ten months immediately preceding each birth.
Both parties ask the Clerk to issue an order establishing paternity for the following child(ren):
(4) Full Name on Birth Certificate
Birthdate
Place of Birth (City, County, State)
This request is based on (check only one box):
(5) [ ]
Genetic Testing and Laboratory Affidavit: Attached is an affidavit from a certified laboratory
indicating that the father named above has not been excluded as the natural father of the
child(ren) named above. By signing this Request, the mother and the father agree to be bound by
the results of this genetic test.
(6) [ ]
Affidavit of Acknowledgment: By signing this Request, the mother and the father agree and
acknowledge that the father named above is the natural father of the child(ren) named above.
The mother and the father ask the Office of Vital Records to amend the birth certificate of each child
listed below to change that child's name as follows.
Page 1 of 2
Revised June 2006
Coconino County Law Library and Self-Help Center Forms
American LegalNet, Inc.
www.FormsWorkflow.com
(7) Change Name From:
(8)
To:
IMPORTANT NOTICE! READ THIS BEFORE YOU SIGN:
A.R.S. 25-812(F) requires that, before you voluntarily acknowledge paternity, you be notified of your alternatives, the legal
consequences, and your rights and responsibilities. Consult an attorney if you are unsure of your rights and responsibilities.
Here are some things you should know:
*
*
*
No one is required to voluntarily acknowledge paternity,
You have the right to seek legal advice before signing this document, and
If you are unsure who the father is, you may have genetic testing done instead of signing this Acknowledgement.
After you agree to voluntarily acknowledge paternity, the Clerk of Court will issue an order legally establishing the father.
This order is the same as a judgment of the Superior Court. This order does not decide issues about custody, child support,
and parenting time. However, after the order is issued, both parents will have all the rights and responsibilities of parents as
required under Arizona law, including the right to seek orders on custody, child support, and parenting time. A.R.S. 25803(D) provides that the parent with whom the child has resided for the greater part of the last six months will have legal
custody unless otherwise ordered by the Court.
Arizona law allows either parent to rescind the acknowledgment of paternity if certain requirements are met. You may have
up to 60 days to do this. See A.R.S. 25-812(H) and A.R.S. Title 25, Chapter 6, Article 1.
(9)
Mother's Signature:
State of Arizona
County of
)
)
)
Subscribed and sworn before me this date:
Seal:
by:
Notary Public:
Notary Expiration Date:
Father's Signature:
State of Arizona
County of
Subscribed and sworn before me this date:
Seal:
Page 2 of 2
Revised June 2006
)
)
)
by:
Notary Public:
Notary Expiration Date:
Coconino County Law Library and Self-Help Center Forms
American LegalNet, Inc.
www.FormsWorkflow.com
