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Stipulation For Voluntary Acknowledgement Of Parentage Form. This is a Massachusetts form and can be use in Bristol County.
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Tags: Stipulation For Voluntary Acknowledgement Of Parentage, 108-CSE-A-35, Massachusetts County, Bristol
YOU MUST READ AND AGREE TO THE UNIFORM PRACTICES OF
PROBATE COURTS BEFORE YOU CAN CONTINUE.
PRACTICE XXXIII. STANDARDS FOR COMPUTER GENERATED FORMS
I. Use. The use of computer generated forms is hereby permitted, except where the
Court blank is a multi-part form, such as wage assignments, Chapter 209A family
abuse forms, cassette copy requests forms, etc. Registers may reject any forms
which fail to comply with these standards. In the event that a Register deems a
submitted form to be outside these standards, such determination will be reviewed
by the Administrative office at the request of Counsel.
II. Specifications.
A. Paper. Twenty pound, alkaline paper shall be used for all computer generated
forms. Alkaline paper is specified to ensure archival quality and permanence.
B. Printing. All computer generated forms shall be printed with “letter quality” or
“near letter quality” output. “Draft” quality output from a nine pin dot matrix
printer is not acceptable.
C. Paper Size. With any pin feeds removed the dimensions of the paper used to
print the computer generated forms shall be the same as those of the official form.
D. Paper and Ink Color. A computer generated form shall be printed on the same
color paper with the same color ink as the official form.
E. Pagination and Punching. The computer generated form shall be printed on
both sides of a single sheet of paper where the official form is so printed to insure
that the computer generated form has the same page arrangement as the official
form. The computer generated form shall duplicate any hole punching that is on
the official form.
F. Page Content. Each page of the computer generated form shall contain the same
information grouped in the same subsections listed in the same order with the same
numerical headings as each page of the official form.
G. Page Format. The computer generated form shall approximately match the
spacing, centering, indentation, margin width and print size of the official form so
that the computer generated form reproduces as closely as possible the appearance
of the official form.
H. Entries. On the computer generated form the entries of information by the
party submitting the form shall be highlighted by either underlining the information
entered or by printing it in boldface letters. The computer generated form shall
provide blank line for the entry of information by the court where such lines are
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provided on the official form.
I. Identification of the Computer Generated Form. A computer generated form
shall bear the initials “c.g.f.” in its lower right hand corner to signify that it is a
computer generated form.
III. Consequences of Failing to Follow These Guidelines. The Probate and Family
Court Department reserves the right to reject any computer generated form which
does not meet the standards set forth above. It is the responsibility of the submitting
party to insure that the form adheres to the above standards. A computer
generated form which does not comply with the above standards may be rejected by
the register, subject to appeal to the Administrative Office. If the form is rejected
the submitting party shall forfeit the filing fee. The submitting party’s attorney
shall not be allowed to pass this cost on to his/her client, but shall bear the financial
burden personally. Accordingly, the submitting party’s attorney shall either
reimburse the client for the forfeited fee or the attorney shall personally pay the
filing fee when he/she re-files the form.
- Uniform Probate Practice XXXIII
____________________________________________________________
INSTRUCTIONS for Form 108/CSE-A-35 - Stipulation for
Voluntary Acknowledgement of Parentage:
____________________________________________________________
1. Form MUST be printed on yellow paper.
2. Second page MUST be printed on back of first page.
3. Parents MUST read and initial second page before it can be
accepted for filing by Court.
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COMMONWEALTH OF MASSACHUSETTS
STIPULATION FOR VOLUNTARY ACKNOWLEDGMENT OF PARENTAGE
THIS IS A LEGAL DOCUMENT. PLEASE PRINT OR TYPE IN BLACK INK.
We acknowledge that we are the biological parents of the following child: (Name of child as it appears on the birth certificate)
\
First
\
Middle
\
who was born in
(Place of Birth)
\
Last
\
on
\
(Date of Birth) Month - spelled out
City/Town/State
Sex (M/F)
Day
Year
We sign this acknowledgment to establish the paternity of this child. We understand that this acknowledgment is a legal document
and that it will have the same binding effect as a judgment of paternity. This acknowledgment may be filed with a court and can form
the basis of a judgment for the support of the child named above. G.L. c. 209C, Section 11. This acknowledgment also may be used
to amend the birth certificate to reflect the names of both parents of this child. G.L. c. 46, Section 13.
MOTHER
(Name of mother as it appears on the birth certificate.)
\
\
Name
First
Middle
\
\
\
Residence
No. & Street Name
City
City or Town
-
-
Social Security #
\
State
Maiden
Zip
State
\
Place of Birth
\
Last
\
\
Date of Birth
Country
Mo.
Yr.
Day
Check one:
I state under oath that when this child was born or conceived, I was not married.
( )
( )
I state under oath that when this child was born or conceived, I was married to someone other than the father of this child. I
understand that this form will not be effective unless it is accompanied by an Affidavit Of Denial of Paternity signed by the man to
whom I was married or unless the court has determined that the man to whom I was married is not the father of this child.
I understand that signing this form establishes paternity. I have been informed of my right to request blood or genetic marker tests but I am
giving up that right or I have taken and received the results of the blood or genetic marker tests. The information above is true to the best
of my knowledge and belief. I have read and understand the information on both sides of this form.
Signature of Mother
and being duly sworn under penalties
day of
,20
FORM READ IN
Then personally appeared before me the above-named
of perjury acknowledged the foregoing to be her free act and deed this
Notary Public:
My Commission Expires:
FATHER
(Name of father as it will appear on the birth certificate.)
\
Name
First
No. & Street Name
Last
\
\
City
City or Town
State
My Mother's Maiden Name
\
State
\
Place of Birth
\
\
Middle
Residence
LANGUAGE
\
-
Social Security #
Zip
Country
-
\
Date of Birth
Mo.
\
Day
Yr.
I understand that signing this form establishes paternity. I have been informed of my right to request blood or genetic marker tests but I
I am giving up that right or I have taken and received the results of the blood or genetic marker tests. The information above is true to the
best of my knowledge and belief. I have read and understand the information on both sides of this form.
Signature of Father
and being duly sworn under penalties
day of
20
FORM READ IN
LANGUAGE
My Commission Expires:
Then personally appeared before me the above-named
of perjury acknowledged the foregoing to be his free act and deed this
Notary Public:
Form 108/CSE-A-35
9/94
bcpfc - c.g.f.
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WHAT DOES IT MEAN IF YOU SIGN THIS FORM?
By signing this acknowledgment of parentage, you are establishing your child's legal paternity. Paternity means
fatherhood. For parents who are not married to one another, paternity may be established legally only by signing this
form or by going to court. Otherwise, your child will have no legal father.
Signing this form is voluntary. Since this form has legal consequences, you may want to consult an attorney before
signing.
u
Paternity is established on the date both parents sign this form. You cannot request blood or genetic
marker tests later. If you want to have a blood or genetic marker test to verify paternity, do not sign this form
until you have received the results of the test. Once signed by both parents and notarized, this form will have
the same binding effect as a court judgment of paternity.
This acknowledgment allows a parent to seek a child support order without further court proceedings to establish
paternity. This acknowledgment may be filed in court and serve as the basis for orders of custody or visitation.
Since you did not sign this form in the hospital, the father's name will not appear on the birth certificate until the birth
certificate is amended. If you want to add the father's name to the birth certificate, you must complete this Stipulation
for Voluntary Acknowledgment of Parentage. You must file the completed form with the court. You must then get a
certified copy of this form from the court and file it with the city or town clerk's office where the child was born to
amend the child's birth certificate. The court will send this form to the Registry of Vital Records and Statistics.
This acknowledgment is not a public record. It will be available only to the parents and child named on this form, the
child's legal guardian or legal representative, or government officials in the conduct of their official duties.
If another man's name is already on the birth certificate and you want to amend the birth certificate to include the
father named on this form, you must file this form with the court.
WHAT ARE YOUR RIGHTS AND RESPONSIBILITIES AS PARENTS?
Both parents are required by law to support their, child from birth. If your child does not live with you, you may be
ordered by the court to pay child support until the child's eighteenth birthday, or beyond in some circumstances.
A parent who does not live with the child may have the right to visit and establish a relationship with the child as you
both agree or as ordered by the court.
For children born of unmarried parents, the mother has custody of the child unless otherwise ordered by the court.
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 has a right to financial support from both of you until age eighteen, or beyond in some circumstances.
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 receive benefits such as dependent or survivor's benefits from the Veteran's
Administration or from the Social Security Administration.
It will be easier for your child to inherit through you.
Mother's Initials
Father's Initials
Questions regarding the birth registration process should be directed to the Registry of Vital Records and Statistics at 617-727-0036.
Questions regarding child support should be directed to the MA Dept. of Revenue, Child Support Enforcement Division at
1-800-332-2733.
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