Mother’s Worksheet
Mother’s Worksheets are required to complete your child’s birth certificate. This certificate, once complete, will be used throughout your child’s life to prove age, citizenship and parentage.
Ready to get started? VSS Portal – Mother’s Worksheet
Information about Establishing Paternity and Paternity Affidavits
Summary of Worksheet Questions
This worksheet collects some of the following pieces of information:
– Child’s full legal name (NOTE: There are no restrictions as to what the last name of the child can be. However, it is recommended there not be any numbers or special characters in the name.) The last name of the child is very important and the parent(s) must choose the last name carefully. Under Wyoming Vital Records Rules and Regulations the last name of the child can only be changed by a court order once filed with the state office.
– Mother’s Current Legal Name: For registration purposes the mother’s current legal name is to be the name she legally uses at the time her child is born.
– Mother’s Maiden Name: The mother’s maiden name actually refers to the mother’s legal name prior to marriage or the mother’s name at her time of birth. This is also the mother’s last name on her own birth certificate. The name prior to first marriage aids in identification of the record, the maiden name of the mother remains constant through life.
– Mother’s Date of Birth: The mother’s date of birth is used to calculate the mother’s age at time of birth. This item is important because it is one of the most important factors in the study of childbearing and pregnancy outcome.
– Mother’s Place of Birth: Record the state or foreign country where the mother was born.
– Mother’s Residence: The mother’s residence is the place where her household is located. Temporary addresses should not be recorded here, examples of these include: address during a vacation, business trip, or during a visit.
Place of residence during a tour of military duty or during attendance at college is NOT considered temporary and should be entered on the worksheet as the mother’s place of residence.
– Is the residence Inside city limits?: If the location entered for the residence is incorporated inside the city boundaries, this item should be marked “YES.” This data item is used in planning for and evaluating community services and facilities, including maternal health programs.
– Mother’s Mailing Address: The address entered should be where all of the mail or other postal items are sent for the mother. This information may or may not be the same as the residence address. This item is particularly important when it comes to receiving the child’s Social Security Card. The card will automatically be sent to this address, if the mother wishes to release information for a Social Security Number for the child.
– Mother’s Education: Please indicate the highest degree or level of school completed at the time of delivery. If the mother is currently enrolled in school, indicate the previous grade or highest degree received. Education is highly related to fertility, health practice, and pregnancy outcome. It is also an indicator of socioeconomic status.
– Cigarette Smoking Before and During Pregnancy: This item provides information on changes in tobacco use before and during pregnancy, which has an important impact on pregnancy outcome.