ACKNOWLEDGMENT OF PATERNITY
(TYPE 2)
________________________________ (Name and Address)
referred to as Mother, and ______________________________ (Name and Address)
referred to Alleged Father, agree Mother is pregnant and is in ______ month of
pregnancy. Father acknowledges paternity of this child.
_________________________ ____________________
Signature of Father Date
_________________________ ____________________
Signature of Mother Date
_________________________ ____________________
Witness for Father Date
_________________________ ____________________
Witness for Mother Date
STATE OF ______________________ COUNTY OF
________________________
On this the ____ day of _________ (Date),
_____________, personally appeared before me, personally known to me (or proved
to me on the basis of satisfactory evidence) to be the person(s) whose name(s)
is/are subscribed to the within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized capacity(ies), and
that by his/her/their signature(s) on the instrument the person(s), or the
entity upon behalf of which the person(s) acted, executed the instrument.
________________________ My commission expires on
Notary Public
STATE OF ______________________ COUNTY OF
________________________
