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Paternity Establishment On The Birth Certificate

Wyoming Statute 35-1-411. Name of father on birth certificate.

(a)  If the mother was married either at the time of conception or birth of child, or between conception and birth, the name of the husband shall be entered on the certificate as the father of the child, unless:

(i)  Paternity has been determined otherwise by a court of competent jurisdiction; or

(ii)  The husband signs an affidavit denying that he is the father and the mother and the person to be named as the father sign an affidavit of paternity under this section. Affidavits may be joint or individual or a combination thereof, and each signature shall be individually notarized. The name of the person signing the affidavit of paternity shall be entered as the father on the certificate of birth.

ALERT!

If the mother provides incorrect or false information concerning her marital status at the time of her child’s birth, it may take a court order to correct the birth certificate once it has been filed with 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 child’s natural father. 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 he will be named at the time the record is registered.

Mother’s Marital Status:  (This is question 7 on the worksheet)

  1.  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.
  2. 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.)

  1. 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 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)

  1. 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 Vital Statistics Services.

General Information on How To Complete the Paternity Acknowledgement

Purpose of the Affidavit Acknowledging Paternity:

This form is used to legally establish who the father of a child is when the birth mother and biological father are not married to each other.  Paternity is defined as a man’s legal role as a father or fatherhood.  The laws regarding this affidavit are found in the Wyoming Parentage Act, W.S. 14-2-401, et seq.

Affidavit Acknowledging Paternity

Affidavit Denying Paternity

Affidavit Acknowledging Paternity-Part II Child 18 Years or Older

Notice Written or Oral:

After downloading this form, and before you complete it, you must read the entire form and/or receive oral notice of the above information.  This notice may be obtained over the telephone by calling (888) 570-9906.  This is a toll free call within the State of Wyoming.

Signing and Filing the affidavit with Vital Statistics Services:

This affidavit is a legal document.  Signing this form is voluntary.  A correctly completed affidavit has the same effect as a court order establishing paternity.  If you do not understand the legal consequences of signing this form, you may want to consult an attorney.  The biological mother and alleged father should not sign this form unless they are sure that the alleged father is the biological father of this child.

The Affidavit Acknowledging Paternity is a legal document that establishes paternity for a child; it names the child’s biological 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 2a– Child’s Sex

Write Male or Female

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.

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 biological 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 BIOLOGICAL father of the child.

Wyoming Department of Health

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