Homepage Indiana Paternity Affidavit 44780 PDF Form
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Establishing paternity is a crucial step in ensuring that a child's rights and benefits are protected, ranging from financial support to emotional bonding with both parents. In Indiana, the Paternity Affidavit 44780 form serves as a vital tool in this process, providing a straightforward path for acknowledging paternity without the need for court intervention. This document, when properly completed and filed, legally establishes a man as a child's father. It is most commonly filled out at the hospital shortly after a child's birth, but it can also be completed at a local health department or child support office. The affidavit makes it possible for the father's name to be added to the birth certificate, thereby granting him rights related to custody, parenting time, and child support. Furthermore, it opens the door for the child to gain access to benefits such as social security, health insurance, and inheritance rights. Understanding the importance and implications of the Indiana Paternity Affidavit 44780 is essential for parents looking to affirm paternity, as it lays the foundational step towards securing a child's future and strengthening the paternal bond.

Example - Indiana Paternity Affidavit 44780 Form

PATERNITY AFFIDAVIT – HOSPITAL USE

State Form 44780 (R7 / 11-17)

INDIANA STATE DEPARTMENT OF HEALTH

Local Health Department Number

File Date (mm/dd/yyyy)

State File Number

 

 

 

Reset Form

Statutory Authority IC 16-37-2 Confidential: IC 16-37-1-10

PA Number

Before I signed any section of this affidavit I was allowed to review it alone and without the presence of the person listed in Section B. Also, I was given the opportunity to consult with an adult of my choosing.

Signature of Mother

Before I signed any section of this affidavit I was allowed to review it alone and without the presence of the person listed in Section C. Also, I was given the opportunity to consult with an adult of my choosing.

Signature of Father

SECTION A – ACKNOWLEDGEMENT OF PATERNITY

We, ____________________________________________ and ____________________________________________ have read and understand the

Father’s full legal name

Mother’s full legal name

consequences, alternatives, rights and responsibilities regarding this affidavit and being duly sworn upon oath depose and say:

I, ______________________________________ am the biological father of _________________________________________, the Child referred to in

Father’s full legal nameChild’s full name at birth – last name same as Mother

SECTION D of this affidavit who was born on __________________ in ________________________ at ________________________, ____________

(mm/dd/yyyy)CityCountyState

________________________________________________________________________________________________________________________.

Hospital or address of location of birth

I, ___________________________________________ whose maiden name is ___________________________________________, am the mother

Mother’s full legal nameMother’s full maiden name

of the child referred to in Section D of this affidavit and that ____________________________________________ is the biological father of that child.

Father’s full legal name

Therefore, I wish for the birth certificate to identify him as the father.

SECTION B – BIOLOGICAL FATHER’S FACTS OF BIRTH

Full Legal Name

 

 

Social Security Number (Pursuant to IC 16-37-2-2.1 (e)(2)(B))

 

Race (optional)

 

 

 

 

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

Place of Birth (city, state,

and county)

 

 

 

 

 

 

 

 

 

 

 

Current Address (number and street, city, state, and ZIP

code)

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

(

)

Name of employer (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of employer (number and street, city, state, and ZIP code) (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

Policy number (optional)

 

 

Medical insurance company (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION C – BIOLOGICAL MOTHER’S FACTS OF BIRTH

 

 

Full Legal Name

 

 

Social Security Number (Pursuant to IC 16-37-2-2.1 (e)(1)(B))

 

Race (optional)

 

 

 

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

Place of Birth (city, state,

and county)

 

 

 

 

 

 

 

 

 

 

 

Current Address (number and street, city, state, and ZIP

code)

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

(

)

Name of employer (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of employer (number and street, city, state, and ZIP code) (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

Policy number (optional)

 

 

Medical insurance company (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION D – CHILD’S NAME ON INDIANA CERTIFICATE OF BIRTH

 

 

It is our mutual desire that the name of our child on the Indiana Certificate of Birth shall be recorded as:

 

 

 

 

 

 

 

 

 

 

 

First

 

Middle

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

Gender of Child

 

 

 

If known, last four (4) digits

child’s Social Security Number

 

 

Male

Female

Not Determined

 

 

 

X X X - X X -

 

 

Page 1 of 2

Local Health Department Number

File Date (mm/dd/yyyy)

State File Number

PA Number

SECTION E – NOTICE OF CONSEQUENCES, ALTERNATIVES, RIGHTS AND RESPONSIBILITIES

By signing this affidavit, I acknowledge that I have read and understand all of the following:

1.A man should NOT sign this form if he is not sure he is the biological father. I may seek a genetic test before signing this form. Signing a Paternity Affidavit is voluntary. I may not be able to reverse paternity and the legal responsibilities of support associated with it, once I sign a Paternity Affidavit.

2.I may sign a Paternity Affidavit at the local Health Department at any time before the child’s emancipation, as long as there is no father listed on the birth certificate.

3.A woman who knowingly or intentionally falsely names a man as the child’s biological father commits a Class A misdemeanor.

4.I received both written and verbal information about the legal effects of signing a Paternity Affidavit.

5.Since this form has legal consequences, I may want to consult an attorney before signing.

6.This affidavit is void if signed more than seventy-two (72) hours after the birth of the child or if signed after the mother has executed a consent to adoption and a petition to adopt has been filed.

7.If I am the presumed father and do not establish paternity now, but want the right to notice and a hearing regarding any adoption of the child, I must register with the Indiana Putative Father Registry through the Indiana State Department of Health.

8.If the mother is receiving or plans to receive public assistance (TANF or Medicaid), she may be required to cooperate in establishing paternity and obtaining a support order or face losing those benefits.

9.If I do not sign a Paternity Affidavit and am unsure about the paternity of the child, I may contact the Prosecuting Attorney’s office in my county for help establishing paternity. They will help arrange tests to establish paternity.

10.The custodial party may contact the Prosecuting Attorney’s Office in their county for the child support services below through the IV-D program.

Establishing paternity

Getting a court order for the payment of child support and medical support

Finding the absent parent

Enforcing child support and medical support orders

11.The completion of this legal document establishes paternity with no further court action required and gives the mother or the IV-D agency the right to obtain a child support order requiring the father to pay support.

12.The father will have parenting time as outlined by the Indiana Parenting Time Guidelines, unless a court rules differently. See www.in.gov/judiciary/rules/parenting.

13.A man has the right to withdraw/rescind his acknowledgment of paternity only within sixty (60) days of the date the Paternity Affidavit is completed. To do so he must file an action in a court with jurisdiction over paternity and may need to submit to and pay for genetic testing per IC 16-37-2-2.1(k- l). After sixty (60) days the father may not be able to reverse paternity, even if genetic tests prove he is not the biological father.

Signature of Mother

Signature of Father

Date (mm/dd/yyyy)

Date (mm/dd/yyyy)

SECTION F – ESTABLISHMENT OF JOINT LEGAL CUSTODY

If both mother and father agree, they may complete this section of the Paternity Affidavit to elect to share joint legal custody of the child named in Section D. Joint legal custody means both mother and father share authority and responsibility for the major decisions concerning the child’s upbringing, including the child’s education, health care and religious training. Also mother and father have equal access to the child’s school and medical records.

(Both signatures are required to share joint legal custody.)

1.

I wish to share joint legal custody of this child with the father listed in Section B of this affidavit.

Signature of Mother (go to 2, then 3): ____________________________________________________

I wish to share joint legal custody of this child with the mother listed in Section C of this affidavit. Signature of Father (go to 2, then 3): _____________________________________________________

2.If you have chosen to share joint legal custody, the mother still has primary physical custody of the child unless another determination is made in a

court proceeding under Indiana Code 31-14.

Initials of Mother: _________ Initials of Father: _________

3.If you agree to share joint legal custody, you MUST submit the results of a genetic test, performed by an accredited laboratory no later than sixty (60) days after the child’s birth, that indicate the father listed in Section B is the biological father of the child. Otherwise, your agreement to share joint legal custody will be void. However the establishment of paternity IS still VALID. Initials of Mother: _________ Initials of Father: _________

4. I do NOT wish to share joint legal custody of this child and I understand this affidavit may still be used to establish paternity if the other sections are properly completed. (Only one signature is required but both may sign.)

Signature of Mother (go to 5): ____________________________________________________

Signature of Father (go to 5): ____________________________________________________

5.If you have chosen NOT to share joint legal custody, the mother has SOLE legal custody unless another determination is made in a court proceeding under Indiana Code 31-14. However the establishment of paternity (SECTIONS A - E) IS still VALID.

Initials of Mother: _________ Initials of Father: _________

Subscribed and sworn to before me, the undersigned, a Notary Public, in and for said county, this ________ day of _______________, 2________.

Signature of Notary

Printed Name of Notary

My Commission Expires (mm,dd,yyyy)

County of Residence

Page 2 of 2

File Information

Fact Number Fact Detail
1 The Indiana Paternity Affidavit Form 44780 is used to establish paternity for a child born to unmarried parents in Indiana.
2 Signing the affidavit is voluntary, and both parents must agree to sign the affidavit for it to be valid.
3 Once signed, the affidavit acknowledges that the male signatory is the biological father of the child.
4 The affidavit allows the father's name to be added to the child's birth certificate.
5 After the affidavit is signed, parents have 60 days to rescind (withdraw) the agreement, if desired.
6 The form is governed by Indiana law, specifically Indiana Code 16-37-2-2.1.
7 Filing the affidavit with the appropriate Indiana state department establishes paternity without needing to go to court.

How to Fill Out Indiana Paternity Affidavit 44780

Once a child is born, acknowledging paternity is a significant step for parents who are not married, as it plays a crucial role in determining custody, visitation rights, and child support. In Indiana, one way to establish paternity is by completing the Paternity Affidavit form 44780. Filling out this document correctly is vital to ensure the legal acknowledgment of paternity. Below are the steps to accurately complete the form.

  1. Start by gathering all necessary information including both parents' full names, social security numbers, dates of birth, and the child's full name and date of birth.
  2. Read through the entire form carefully to understand all the information that is required and the declarations you are making by signing the form.
  3. In the section designated for the child’s information, fill in the child’s full name as it appears on the birth certificate, along with their place and date of birth.
  4. Enter both parents' information where indicated. This includes your names, social security numbers, races, dates of birth, and addresses. Ensure that all spellings are correct and match your legal documents.
  5. Pay special attention to the section regarding custody and child support. This part of the form may require you to agree on certain responsibilities. If unsure, consider seeking legal advice.
  6. Look for any sections that require initialing, indicating that you understand or agree to the specific statements. Each parent should initial next to these statements as required.
  7. Both parents must sign and date the form in the designated areas in the presence of a notary public or the hospital staff authorized to notarize the document.
  8. Review the entire form for accuracy and completeness before submitting it to ensure all provided information is correct and no sections have been missed.
  9. Follow the instructions provided by the hospital or local health department for submitting the completed form. This may involve handing it over to hospital staff if the child is just born or sending it to a specific state department.

After successfully submitting the Paternity Affidavit, it's essential to keep a copy for your records. The acknowledgment of paternity impacts several parental rights and responsibilities. Understanding the legal implications of this document is crucial, as it is a formal declaration of paternity. If there are any doubts or concerns, seeking legal guidance is a responsible step forward.

Things to Know About Indiana Paternity Affidavit 44780

What is the Indiana Paternity Affidavit 44780 form?

The Indiana Paternity Affidavit 44780 form is a legal document used to establish paternity when a child is born to unmarried parents in the state of Indiana. By signing this affidavit, the father acknowledges paternity of the child, which is crucial for legal, financial, and emotional reasons. It enables the child to have access to the father's medical history, benefits such as health insurance and social security, and supports the establishment of a legal relationship between the father and the child.

Who needs to sign the Indiana Paternity Affidiffit 44780 form?

Both the biological mother and the father of the child need to sign the Indiana Paternity Affidavit 44780 form. Their signatures must be witnessed by a healthcare professional or a notary public. This process is typically done at the hospital or medical facility soon after the child’s birth, but it can also be completed later at a local health department or the office of a healthcare provider who can offer notary services.

Can the Indiana Paternity Affidavit 44780 form be rescinded or challenged?

Yes, the Indiana Paternity Affidavit 44780 form can be rescinded within 60 days of signing. To do this, either parent must file a rescission form with the Indiana State Department of Health. After the 60-day period, challenging the acknowledged paternity becomes significantly more complicated and often requires legal intervention. A court may only grant a challenge to paternity based on fraud, duress, or material mistake of fact, and usually requires genetic testing.

What happens if the Indiana Paternity Affidavit 44780 form is not signed?

If the Indiana Paternity Affidavit 44780 form is not signed, paternity is not legally established, and the father's name will not be placed on the child's birth certificate. Without established paternity, the child may not be eligible for certain benefits from the father, including health insurance, inheritance rights, and social security benefits. Additionally, the father may not have legal rights concerning custody, parenting time, or decision-making for the child unless paternity is established through a court order at a later time.

Common mistakes

When it comes to establishing paternity, Indiana's Paternity Affidavit, form 44780, is a key document. However, a number of common mistakes can complicate this process unnecessarily. Understanding these pitfalls can help ensure the process goes smoothly for everyone involved.

  1. Not reviewing the form for accuracy before signing. It's crucial to double-check every piece of information on the affidavit. Small errors, such as misspelled names or the wrong date of birth, can lead to big headaches down the road. These mistakes can require legal action to correct and delay the establishment of paternity rights and responsibilities.
  2. Failing to understand the legal implications. This document is not just a formality; it has significant legal implications, including financial responsibilities and parental rights. Parents should fully understand what signing the affidavit means. If there's any confusion, seeking advice from a legal expert before signing is wise.
  3. Ignoring the timeframe for submission. There's a specific window of time within which the affidavit needs to be submitted for it to be processed smoothly. Missing this deadline can delay the establishment of paternity. Always check the latest submission guidelines and deadlines.
  4. Omitting required information. Every field on the form is crucial. Leaving a section blank or failing to provide required documentation can result in the rejection of the affidavit. If you're unsure about what a section requires, it's better to seek clarification than to leave it incomplete.
  5. Using incorrect or unofficial forms. Only the latest version of the official Indiana Paternity Affidavit 44780 form should be used. Sometimes, outdated or unofficial forms circulate online. Submitting the wrong form can nullify the affidavit's validity.
  6. Not retaining a personal copy of the completed affidavit. After submitting the affidavit, keeping a copy for personal records is essential. This document is an official record of paternity and may be needed for future reference, such as for enrolling the child in school or applying for government services.

By avoiding these common mistakes, parents can help ensure that the process of establishing paternity in Indiana is as smooth and straightforward as possible. It's about making sure everything is in order for the sake of all involved, especially the child. Remember, when in doubt, it doesn't hurt to ask a professional for advice. Doing so can save a lot of time and effort down the line.

Documents used along the form

When filling out the Indiana Paternity Affidavit 44780 form, it's often not the only piece of paperwork you'll need to complete. This document is crucial for establishing paternity, but it's typically part of a larger process that may require additional forms and documents. Whether you're a new parent looking to confirm paternity or navigating the legal implications of doing so, understanding what other documents you might need can streamline the process. Here's a guide to other forms and documents usually used alongside the Indiana Paternity Affidavit 44780.

  • Birth Certificate Registration Form: This is required to officially record the birth of a child. The information from the Paternity Affidavit helps complete this document, especially in acknowledging the father's details.
  • Application for Social Security Card: Necessary for obtaining a social security number for the newborn. Paternity information may affect the benefits the child can receive.
  • Child Support Worksheet: Used to calculate the amount of child support the non-custodial parent must pay. Establishing paternity is a critical step before this can be accurately completed.
  • Voluntary Acknowledgment of Parentage: While the Paternity Affidavit serves a similar purpose, this document might be used in certain cases to further assert the biological and legal ties between a father and his child.
  • Child Custody and Visitation Agreement: This form outlines the agreement between parents about raising their child, including who has custody and the visitation rights. It’s often needed once paternity is established.
  • Health Insurance Coverage Form: This document is used to add the child to a parent's health insurance plan. Proof of paternity may be required by the insurance company to extend coverage to the child.
  • Modification of Child Support Form: If there are changes in income, custody, or other factors affecting child support, this form needs to be completed to adjust the child support orders accordingly.
  • Denial of Paternity Form: In situations where there is a dispute or a reevaluation of paternity, this form can be used to formally deny paternity previously claimed or assigned.

Dealing with legal documents can be overwhelming, especially at such a pivotal time as the birth of a child. However, being prepared with the right forms and understanding what each is used for can significantly ease the process. Whether you're establishing paternity, seeking to understand your rights, or complying with legal requirements, these documents are typically part of the journey. Keep in mind, the specifics of what's required can vary, so it's always a good idea to check current state laws and guidelines or consult with a legal expert to ensure you're covering all your bases.

Similar forms

The Indiana Paternity Affidavit 44780 form is similar to other vital records documents that establish legal relationships and rights. These documents play critical roles in legal, social, and economic contexts. They are crucial for accessing a variety of services and benefits, from health insurance to inheritance. Among them, some notable examples include the Birth Certificate and the Acknowledgment of Paternity form. Each serves a unique purpose but shares commonalities with the Indiana Paternity Affidavit in terms of their function and significance.

The Birth Certificate is a primary document, similar to the Indiana Paternity Affidavit, in that it officially records an individual's birth and parental information. Both documents are essential for proving identity, age, and parental relationships. Where the Birth Certificate provides a comprehensive record of a child's birth details, the Indiana Paternity Affidavit specifically establishes the father's legal paternity. This affidavit can be vital in scenarios where a Birth Certificate does not automatically include the father's name, such as in cases where the parents are not married at the time of the child's birth.

The Acknowledgment of Paternity form is another document closely aligned with the Indiana Paternity Affidavit. They both serve to legally establish paternity but may be used in different contexts. While the Paternity Affidavit can be completed and filed at the hospital shortly after a child's birth, the Acknowledgment of Paternity might be used at a later time, sometimes following legal proceedings or DNA testing. Despite these differences in application, both documents are crucial for affirming a father's legal responsibilities and rights to his child.

Dos and Don'ts

In Indiana, establishing paternity through the Paternity Affidavit 44780 form is an important step for unmarried parents. Making sure it's done correctly ensures the legal rights of the parent and child are protected. Here are some crucial dos and don'ts to keep in mind when filling out this form:

Do:
  1. Read the entire form carefully before starting to fill it out. Understanding each section can help prevent mistakes.
  2. Fill out the form with accurate, current information. This includes names, addresses, and any other personal information requested.
  3. Use black ink, as it is more likely to be legible and is often required for official documents.
  4. Sign the form in the presence of a notary public or a qualified witness as required. Their verification is essential to the document's validity.
  5. Keep a copy of the completed form for your records. Having your own copy can be very helpful for future reference.
  6. Submit the form to the appropriate Indiana state office or as instructed by the hospital or birthing center. Timely submission is critical.
Don't:
  1. Leave blanks on the form. If a section does not apply, write “N/A” (not applicable) rather than leaving it empty.
  2. Rush through the form without double-checking the information provided. Errors can complicate the paternity establishment process.
  3. Use a pencil or any ink color other than black. This can cause issues with the legibility and official acceptance of the document.
  4. Forget to verify the identity of the other parent signing the form, if applicable. This helps ensure the accuracy and legitimacy of the information.
  5. Overlook the need for a witness or notary public. Their signature is a required step for validating the form.
  6. Ignore instructions or deadlines provided by the hospital, birthing center, or state office. These guidelines are put in place to ensure the process goes smoothly.

By following these dos and don’ts, you can help make sure that the Indiana Paternity Affidavit 44780 form is completed correctly and efficiently, laying a solid foundation for your child's legal rights.

Misconceptions

The Indiana Paternity Affidavit 44780 form is a legal document that can significantly impact the lives of parents and their child. Despite its importance, there are several misconceptions surrounding this form. By clarifying these, individuals can make more informed decisions about paternity establishment.

  • Signing does not establish paternity immediately. It is commonly misunderstood that the act of signing the Indiana Paternity Affidavit 44780 form instantly validates paternity. In reality, the document must be properly processed and filed with the appropriate state agency to legally establish paternity.
  • Legal advice is not necessary before signing. Many believe that consulting a lawyer is unnecessary before signing this affidavit. However, understanding the legal implications of acknowledging paternity is crucial, as it affects parental rights, child support, and custody matters. Seeking legal advice is always recommended.
  • The mother's signature is enough to establish paternity. This is a misconception. Both the mother and the alleged father must sign the affidavit to establish paternity, except in cases where the mother is unavailable or unwilling to sign, and additional legal steps may be needed.
  • There are no deadlines for signing. Many people are under the impression that the Indiana Paternity Affidavit 44780 can be signed at any time. There are, in fact, specific timelines within which the affidavit must be signed post-childbirth for it to be accepted without the need for a court order.
  • Signing the affidavit guarantees parental rights. While establishing paternity is a step towards legal recognition as a parent, it does not automatically grant custody or visitation rights. These rights often require further legal action in court.
  • Any alterations invalidate the form. It's assumed that making any correction or alteration on the affidavit invalidates it entirely. Minor, necessary corrections are usually acceptable as long as they are initialed by the parties involved.
  • Only the father needs to provide identification when signing. Both parents are required to provide valid identification when signing the paternity affidavit to ensure accuracy and legitimacy of the document.
  • The form can be signed before the child is born. Contrary to this belief, the Indiana Paternity Affidavit 44780 cannot be legally signed and processed until after the child's birth.
  • Paternity can only be disputed in court. While disputes often end up in court, signing the affidavit is not a final or irreversible action. There is a limited period during which either party can rescind their acknowledgment of paternity under specific circumstances.
  • The process is the same in every state. Some people mistakenly believe that the process and rules for establishing paternity are uniform across the United     States. In reality, each state has its own procedures, forms, and laws governing paternity establishment. The Indiana Paternity Affidavit 44780 is specific to Indiana.

Understanding these misconceptions about the Indiana Paternity Affidavit 44780 form is essential for parents and individuals involved in the process. Establishing paternity has significant legal and personal consequences, and all parties should proceed with clear knowledge and consider seeking legal counsel where necessary.

Key takeaways

When dealing with the Indiana Paternity Affidavit 44780 form, understanding its purpose and implications is crucial. This document plays a significant role in recognizing the legal fatherhood of a child, which has lasting effects on the child's and parents' rights and responsibilities. Here are four key takeaways to keep in mind:

  • Accuracy is crucial. Every piece of information provided in the affidavit needs to be accurate and truthful. Mistakes can lead to legal complications and may require further legal action to correct.
  • Voluntariness is a must. Both parties, the mother and the presumed father, must sign the affidavit voluntarily. There should be no pressure or coercion involved. Understanding the full implications of signing is important, as it establishes legal fatherhood.
  • Timing matters. The affidavit can be signed at the hospital immediately after the birth of the child or at a later time. However, delaying its completion can complicate matters, especially in seeking child support or in cases where paternity might be contested later on.
  • Revocation is possible but limited. Once signed, there is a brief period (usually 60 days, though this can vary) during which the affidavit can be rescinded by either parent. After this period, challenging paternity established by the affidavit requires going through the court system and can be difficult unless there is clear evidence of fraud or mistake.

It's advisable for all parties involved to seek legal advice or guidance when filling out the Indiana Paternity Affidavit 44780 form. This ensures that the rights and obligations of the parents and the child are clearly understood and properly protected.

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