IN THE SUPERIOR OF FULTON COUNTY STATE OF GEORGIA FAMILY DIVISION Petitioner: ________________________ , and Respondent: ______________________ . Civil Action File No. __________ ORDER The above and foregoing Petition coming on before me, it is considered, Ordered and adjudged that: The child(ren) named in the Petition, _______________________________, female/male, born ___________, in Fulton County, Georgia, are declared the legitimate child(ren) of Petitioner and capable of inheriting from him. The surname(s) of the minor child(ren) is hereby changed to _____________________ and shall be changed on the birth record of the child(ren). The name of ____________ _____________________ shall be removed from the birth record of said child(ren) and Petitioner's name _____________________________________ shall be entered on the birth record of the child(ren) as the father of said child(ren). The Department of Vital Statistics is ordered and directed to amend the birth record of said child(ren) accordingly, and to reissue birth certificate(s) showing Petitioner __________________ __________________________________ as father and changing the child(ren)'s name to _________________________________________________. Custody is awarded as follows: _____________________________________________________________________ The Petitioner,_____________________________________, is hereby awarded specific rights of visitation with the minor child(ren) as follows: Attached and incorporated in this Order is the Child Support Addendum. The issues of Child support and health insurance is Ordered as outlined in the Child Support Addendum. This _______ day of _____________________, ______. _____________________________________ Judge, Fulton Superior Court Atlanta Judicial Circuit Order-legitimation revised 07/2012 © 1999 Fulton County Superior Court Family Division American LegalNet, Inc. www.FormsWorkFlow.com 1 f 1