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Petition/Paternity Claim PC-907 Petition / Paternity Claim CONNECTICUT PROBATE COURTS PC - 907 REV. 1/19 Page 1 of 2 RECEIVED: Instructions: 1)Any person claiming to be the father of a child born out of wedlock may use this form to petition the court to establish that he is the father of the child pursuant to C.G.S. section 46b-172a. 2)If the putative father of the child born out of wedlock is deceased, a person with a sufficient interest inestablishing paternity for the decedent may file the petition with the court.3)For a child born on or after July 1, 1997, a petition to establish paternity may only be filed in the ProbateCourt if there is no other person listed as the father on the child222s birth certificate.4)The petition should be filed in the probate district in which either the mother or the child resides,together with the JD-FM-164, Affidavit Concerning Children.5)Type or print the form in ink. Use an additional sheet, or Second Sheet, PC-180, if more space is needed. Probate Court Name District Number Persons to Whom Notice Should Be Given (Names, addresses and relationships to child. C.G.S. section 46b-172a) Was the mother married at the time of the child222s birth? Yes No (If yes, list name and address of that spouse.) there another man listed as the father on the birth certificate? If yes, list name and address.) In the Matter of ( N ame and address of child) Place and Date of C hild222s Birth ( or Month and Year of Expected Birth Mother ( N ame , address and tele phone number ) Mother222s Date of Birth Claimant /Putative Father ( N ame, address and telephone number) Putative Father 222s Date of Birth Petitioner, if putative father deceased (Name, address and telephone number) Putative Father222s Date of Death, If Deceased American LegalNet, Inc. www.FormsWorkFlow.com Petition/Paternity Claim PC-907 Petition /Paternity Claim CONNECTICUT PROBATE COURTS PC - 907 REV. 1/19 Page 2 of 2 If the putative father is deceased, state the petitioner222s interest in establishing the paternity of the putative father. THE PETITIONER REPRESENTS that: The last known address(es) of the mother and child are listed above. He is the father of the above-named child and will offer evidence of his paternity. He understands that the claim for paternity shall be admissible in any action for paternity brought under C.G.S. section 46b-160 and shall bar him from denying his paternity of the child. By filing this claim, he acknowledges liability for contribution to the support and education of the child after its birth and for contribution to the pregnancy-related medical expense of the mother. The putative father is deceased, and the petitioner will offer evidence of his paternity. The petitioner further represents that to the best of his or her knowledge and belief: The minor child has resided has not resided in Connecticut continuously for the last six months. There is a proceeding is not a proceeding pending or contemplated in Connecticut or any other state affecting the custody of the minor child. There has been a proceeding has not been a proceeding in the past in Connecticut or any other state affecting the custody of the minor child. THEREFORE, the claimant/petitioner requests that: The court determine that the claimant/putative father is the father of the child. The court change the name of the child to: The representations contained herein are made under penalty of false statement. Signature of the Claimant/Petitioner Date American LegalNet, Inc. www.FormsWorkFlow.com