(Name and Address) referred to as Mother, and _____________________________
(Name and Address) referred to Alleged Father, agree:
is pregnant in approximately the ____________________ month of pregnancy.
Mother claims that Alleged Father is the Father of the child. Alleged Father disputes the claims of Mother
and does not admit paternity of the child.
parties desire to resolve this matter without the uncertainties and expense of
In consideration of the agreement herein, Mother agrees that she will not bring
any proceeding for paternity before any court or administrative agency. Mother
herewith releases the Alleged Father from any and all claims related to the
paternity and support of the child.
consideration of the terms and conditions provided herein, Alleged Father shall
pay to Mother the sum of $ ____________ the sufficiency of which as adequate
agreed on/before ___________(date). In
the event that the consideration is not timely paid this agreement shall be of
This is the agreement between the
parties. Any modification to this
be required to be in writing.
of Mother Date
of Alleged Father Date