If the mother provides incorrect or false information concerning her marital status at the time of birth for her child, it may take a court order to correct the birth certificate once it has been filed with the Office of Vital Statistics Services.
Mother’s Marital Status on the Birth Certificate
When completing the “Mother’s Worksheet for Child’s Birth Certificate”, the mother is asked to provide information about her marital status and the natural father of the child. The following items MUST be answered very carefully, failure to do so will impact the paternity establishment for the child. Simply because the mother lists the father’s name on the worksheet, does not guarantee that he will be named at the time the record is registered.
Mother’s Marital Status: (This is question 7 on the worksheet)
- Was the mother married to anyone at the time of conception, birth or anytime in between? Choose YES or NO.
- If the mother was MARRIED at the time of birth, the mother needs to mark YES.
- If the mother was going through a separation or divorce, but not yet divorced, she must check YES.
- If YES, is her husband the father of the child? Choose YES or NO. This question is asking if your husband is the father of the child.
- If the mother was MARRIED and her husband IS the father, the mother needs to mark YES.
- If the mother was MARRIED and her husband IS NOT the father, the mother needs to mark NO.
Paternity Acknowledgement: (This is question 8 on the worksheet and only needs to be answered if the mother WAS NOT MARRIED to the natural father.)
- Has the father signed an Affidavit Acknowledging Paternity? Choose either YES or NO.
- If the mother WAS NOT married at the time birth and wishes to name the father on the child’s birth certificate, this must be answered YES. Both the mother and natural father are to complete the Affidavit Acknowledging Paternity and sign in front of a Notary Public. For each signature, there must be notary seal.
- If the mother and natural father have not signed an Affidavit Acknowledging Paternity, the father can’t be listed on the certificate until the Affidavit is completed and filed with the Office of Vital Statistics Services.
Paternity Denial: (This item only needs to be answered if the mother WAS MARRIED but the husband is not the natural father of the child)
- If the mother was married, has her husband signed an Affidavit Denying Paternity? Choose either YES or NO.
- If the mother was married, the husband is NOT the natural father of the child, and the natural father wishes to be named on the certificate as the father. The mother and natural father must complete an Affidavit Acknowledging Paternity as mentioned above and the husband must complete an Affidavit Denying Paternity and sign in front of a Notary Public. Both affidavits are legal documents and need to be submitted to the Office of Vital Statistics Services.
General Information on How To Complete the Paternity Acknowledgement
The Affidavit Acknowledging Paternity is a legal document that establishes paternity for a child, it names the child’s natural father. These instructions are meant to help when completing this Affidavit. If you make any errors while completing the Affidavit Acknowledging Paternity, please obtain and complete a new Affidavit. This Affidavit is a legal document and as such needs to be complete and contain accurate information. While completing the Affidavit, please be sure to complete ALL items.
Box 1 – Child’s full name at birth
Write out the first, middle, and last name of your baby. This must be exactly the same as the name you put on your baby’s birth certificate.
Box 2 – Child’s date of birth
You can write this out as Sept. 1, 2008 OR you can use numbers 09/01/2008 for the date of birth.
Box 3 – Child’s place of birth – City, County, State
Write the city your child was born in, the county, and the state. For example,
City – Cheyenne
County – Laramie
State – Wyoming
If you do not know the name of the county, please click here. (This file is a PDF document and must have Adobe installed to view).
Box 4 – Child’s name shall be shown on the birth certificate as
Leave this box blank if you are not changing your baby’s last name as you wrote it in Box 1. Fill it out only if you are changing your baby’s last name. If you change your baby’s last name in this box, it will be the new official name on your baby’s birth certificate.
Box 5 – Mother’s name
Write your name in this box. It should be the same legal name that was put on your child’s birth certificate.
Box 6 – Mother’s maiden name
Write your original last name, the one shown on your own birth certificate.
Box 7 – Mother’s date of birth
Write your complete date of birth. Sept. 1, 2008 OR you can use numbers 09/01/2008 for the date of birth.
Box 8 – Mother’s social security number
Write your complete social security number. If you were born in a foreign country and DO NOT have a SSN, please enter N/A or None. DO NOT LEAVE THIS ITEM BLANK.
Box 9 – Mother’s mailing address
Write out your complete address where you receive your mail.
Box 10 – Were you married to someone other than the natural father of this child at any time within 300 days prior to this birth?
You must check either yes or no.
Box 11 – If yes, name of husband or ex-husband
If you were married at any time while you were pregnant, you must fill in the name of your husband. Even if you filed for divorce or your divorce was final while you were pregnant, you must put your husband’s name in this box.
If box 10 is yes and there is a name listed, there MUST be a Notarized Affidavit Denying Paternity from this person. If you are completing this form at the hospital ask the Health Information Management or Medical Records for this form or you may contact Vital Statistics Services for this form.
Box 12 – Father’s name
Who is the father of your child? Write his name here. It should be written exactly the same as you wrote on your child’s birth certificate.
Box 13 – Father’s state of birth
If your baby’s father was born in the United States, write the name of the state where he was born. If your baby’s father was born in another country, write the name of the country in this box.
Box 14 – Father’s date of birth
Fill this blank out like you did in boxes 2 and 7.
Box 15 – Father’s social security number
Fill in the social security number of the baby’s father. If he was born in another country and does not have a social security number, enter N/A or NONE. DO NOT LEAVE THIS ITEM BLANK.
Box 16 – Father’s mailing address
Fill out the complete mailing address, including street, city, state, and zip code.
Box 17 – Have you submitted to genetic testing to determine if you are the natural father of this child?
If the father has had a DNA test to determine if he is the father, check yes. If he has not done this, check no.
If yes, did the test results show that you are the father of this child?
Check yes if the DNA test results showed he is the father. If he has had a DNA test and the results show he is not the father, STOP! Do not sign this form, it is now invalid. The Paternity Affidavit is only to be completed by the NATURAL father of the child.