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Mothers Affidavit Of Paternity Form. This is a Oklahoma form and can be use in District Court Statewide.
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Tags: Mothers Affidavit Of Paternity, Oklahoma Statewide, District Court
*03PA001E-001*
OKLAHOMA DEPARTMENT OF HUMAN SERVICES
Mother's Affidavit of Paternity
(One affidavit for each father)
OFFICE USE ONLY
Name:
Case no.:
Court case no.:
OK IV-D case no.:
I swear that
is the father of:
Child(ren)'s name
State of birth
Date of birth
and I am the natural mother.
I understand that genetic testing may be used to determine who the father of the
child(ren) is and I agree to submit myself and my child(ren) to this testing as necessary.
I understand the penalty for perjury on a document that is going to be used in a
judicial proceeding is five years in prison and a $1000 fine. I state under penalty of
perjury under the laws of Oklahoma that the foregoing is true and correct.
Please sign and date the form and have it witnessed.
Date
Signature of mother
Witness
If you cannot truthfully swear who is the father of the children, please state why:
Mail this form to your Oklahoma Department of Human Services (OKDHS) county
office. The OKDHS county office forwards Form 03PA001E to the appropriate OKDHS
Child Support Enforcement Division (CSED) district office.
OKDHS revised 7-1-2004
03PA001E (CSED-1-B)
Page 1 of 2
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03PA001E (CSED-1-B)
Mother’s Affidavit of Paternity
Purpose of form
Form 03PA001E is completed, signed, and dated by the mother of a child(ren) for whom
paternity has not been established. Depending upon the circumstances, Form 03PA001E
may not be the only form required to establish and enforce child support orders.
Instructions for preparation of form
1. Use a black ink pen to complete Form 03PA001E.
2. Complete one Form 03PA001E for each father.
3. Sign and date Form 03PA001E in the presence of a witness and have that person
sign Form 03PA001E in the space provided next to the mother’s signature.
4. Return the original Form 03PA001E to the Oklahoma Department of Human
Services (OKDHS), Family Support Services (FSS) intake worker. The FSS
intake worker forwards Form 03PA001E to the appropriate OKDHS Child
Support Enforcement Division (CSED) district office.
5. If Form 03PA001E is not completed at the time of application for services, it
must be completed and returned within ten days of the notice of certification
for services.
Page 2 of 2
OKDHS revised 7-1-2004
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