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Indiana Paternity Affidavit 44780 Form in PDF

The Indiana Paternity Affidavit 44780 form is a legal document used in the state of Indiana. It establishes paternity for a child when the parents are not married, providing the child with the same legal rights and benefits as those whose parents are married. This form is an essential step for parents looking to acknowledge paternity officially.

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Indiana Paternity Affidavit 44780 Form in PDF

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Establishing paternity is a significant step in ensuring that a child receives the care, support, and benefits they deserve from both parents. In Indiana, the Paternity Affidavit 44780 form plays a crucial role in this process, particularly for children born to unmarried parents. This legally binding document allows the establishment of paternity without the need to go through court proceedings, making it a simpler and more direct path for acknowledging a father's legal relationship to a child. Completing the form accurately is essential as it affects various aspects of a child’s life, including entitlement to financial support, access to medical records, and eligibility for health insurance from either parent. Additionally, it paves the way for the father's name to be added to the birth certificate, which is a significant step in recognizing and formalizing the father-child relationship. Being well-informed about the implications and requirements of the Indiana Paternity Affidavit 44780 form is imperative for parents wishing to secure their child's rights and benefits.

Sample - Indiana Paternity Affidavit 44780 Form

PATERNITY AFFIDAVIT – HOSPITAL USE

State Form 44780 (R7 / 11-17)

INDIANA STATE DEPARTMENT OF HEALTH

Local Health Department Number	File Date (mm/dd/yyyy)	State File Number

Reset Form

Statutory Authority IC 16-37-2 Confidential: IC 16-37-1-10

PA Number

Before I signed any section of this affidavit I was allowed to review it alone and without the presence of the person listed in Section B. Also, I was given the opportunity to consult with an adult of my choosing.

Signature of Mother

Before I signed any section of this affidavit I was allowed to review it alone and without the presence of the person listed in Section C. Also, I was given the opportunity to consult with an adult of my choosing.

Signature of Father

SECTION A – ACKNOWLEDGEMENT OF PATERNITY

We, ____________________________________________ and ____________________________________________ have read and understand the

Father’s full legal name

Mother’s full legal name

consequences, alternatives, rights and responsibilities regarding this affidavit and being duly sworn upon oath depose and say:

I, ______________________________________ am the biological father of _________________________________________, the Child referred to in

Father’s full legal nameChild’s full name at birth – last name same as Mother

SECTION D of this affidavit who was born on __________________ in ________________________ at ________________________, ____________

(mm/dd/yyyy)CityCountyState

________________________________________________________________________________________________________________________.

Hospital or address of location of birth

I, ___________________________________________ whose maiden name is ___________________________________________, am the mother

Mother’s full legal nameMother’s full maiden name

of the child referred to in Section D of this affidavit and that ____________________________________________ is the biological father of that child.

Father’s full legal name

Therefore, I wish for the birth certificate to identify him as the father.

SECTION B – BIOLOGICAL FATHER’S FACTS OF BIRTH

Full Legal Name			Social Security Number (Pursuant to IC 16-37-2-2.1 (e)(2)(B))			Race (optional)

Date of Birth (mm/dd/yyyy)		Place of Birth (city, state,	and county)

Current Address (number and street, city, state, and ZIP		code)				Telephone number
						(	)
Name of employer (optional)

Address of employer (number and street, city, state, and ZIP code) (optional)
					Policy number (optional)
Medical insurance company (optional)					Policy number (optional)

	SECTION C – BIOLOGICAL MOTHER’S FACTS OF BIRTH
Full Legal Name			Social Security Number (Pursuant to IC 16-37-2-2.1 (e)(1)(B))			Race (optional)

Date of Birth (mm/dd/yyyy)		Place of Birth (city, state,	and county)

Current Address (number and street, city, state, and ZIP		code)				Telephone number
						(	)
Name of employer (optional)

Address of employer (number and street, city, state, and ZIP code) (optional)
					Policy number (optional)
Medical insurance company (optional)					Policy number (optional)

	SECTION D – CHILD’S NAME ON INDIANA CERTIFICATE OF BIRTH
It is our mutual desire that the name of our child on the Indiana Certificate of Birth shall be recorded as:

First		Middle			Last

Gender of Child				If known, last four (4) digits	child’s Social Security Number
Male	Female	Not Determined			X X X - X X -

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Local Health Department Number

File Date (mm/dd/yyyy)

State File Number

PA Number

SECTION E – NOTICE OF CONSEQUENCES, ALTERNATIVES, RIGHTS AND RESPONSIBILITIES

By signing this affidavit, I acknowledge that I have read and understand all of the following:

1.A man should NOT sign this form if he is not sure he is the biological father. I may seek a genetic test before signing this form. Signing a Paternity Affidavit is voluntary. I may not be able to reverse paternity and the legal responsibilities of support associated with it, once I sign a Paternity Affidavit.

2.I may sign a Paternity Affidavit at the local Health Department at any time before the child’s emancipation, as long as there is no father listed on the birth certificate.

3.A woman who knowingly or intentionally falsely names a man as the child’s biological father commits a Class A misdemeanor.

4.I received both written and verbal information about the legal effects of signing a Paternity Affidavit.

5.Since this form has legal consequences, I may want to consult an attorney before signing.

6.This affidavit is void if signed more than seventy-two (72) hours after the birth of the child or if signed after the mother has executed a consent to adoption and a petition to adopt has been filed.

7.If I am the presumed father and do not establish paternity now, but want the right to notice and a hearing regarding any adoption of the child, I must register with the Indiana Putative Father Registry through the Indiana State Department of Health.

8.If the mother is receiving or plans to receive public assistance (TANF or Medicaid), she may be required to cooperate in establishing paternity and obtaining a support order or face losing those benefits.

9.If I do not sign a Paternity Affidavit and am unsure about the paternity of the child, I may contact the Prosecuting Attorney’s office in my county for help establishing paternity. They will help arrange tests to establish paternity.

10.The custodial party may contact the Prosecuting Attorney’s Office in their county for the child support services below through the IV-D program.

●	Establishing paternity	●	Getting a court order for the payment of child support and medical support
●	Finding the absent parent	●	Enforcing child support and medical support orders

11.The completion of this legal document establishes paternity with no further court action required and gives the mother or the IV-D agency the right to obtain a child support order requiring the father to pay support.

12.The father will have parenting time as outlined by the Indiana Parenting Time Guidelines, unless a court rules differently. See www.in.gov/judiciary/rules/parenting.

13.A man has the right to withdraw/rescind his acknowledgment of paternity only within sixty (60) days of the date the Paternity Affidavit is completed. To do so he must file an action in a court with jurisdiction over paternity and may need to submit to and pay for genetic testing per IC 16-37-2-2.1(k- l). After sixty (60) days the father may not be able to reverse paternity, even if genetic tests prove he is not the biological father.

Signature of Mother

Signature of Father

Date (mm/dd/yyyy)

SECTION F – ESTABLISHMENT OF JOINT LEGAL CUSTODY

If both mother and father agree, they may complete this section of the Paternity Affidavit to elect to share joint legal custody of the child named in Section D. Joint legal custody means both mother and father share authority and responsibility for the major decisions concerning the child’s upbringing, including the child’s education, health care and religious training. Also mother and father have equal access to the child’s school and medical records.

(Both signatures are required to share joint legal custody.)

I wish to share joint legal custody of this child with the father listed in Section B of this affidavit.

Signature of Mother (go to 2, then 3): ____________________________________________________

I wish to share joint legal custody of this child with the mother listed in Section C of this affidavit. Signature of Father (go to 2, then 3): _____________________________________________________

2.If you have chosen to share joint legal custody, the mother still has primary physical custody of the child unless another determination is made in a

court proceeding under Indiana Code 31-14.

Initials of Mother: _________ Initials of Father: _________

3.If you agree to share joint legal custody, you MUST submit the results of a genetic test, performed by an accredited laboratory no later than sixty (60) days after the child’s birth, that indicate the father listed in Section B is the biological father of the child. Otherwise, your agreement to share joint legal custody will be void. However the establishment of paternity IS still VALID. Initials of Mother: _________ Initials of Father: _________

4. I do NOT wish to share joint legal custody of this child and I understand this affidavit may still be used to establish paternity if the other sections are properly completed. (Only one signature is required but both may sign.)

Signature of Mother (go to 5): ____________________________________________________

Signature of Father (go to 5): ____________________________________________________

5.If you have chosen NOT to share joint legal custody, the mother has SOLE legal custody unless another determination is made in a court proceeding under Indiana Code 31-14. However the establishment of paternity (SECTIONS A - E) IS still VALID.

Initials of Mother: _________ Initials of Father: _________

Subscribed and sworn to before me, the undersigned, a Notary Public, in and for said county, this ________ day of _______________, 2________.

Signature of Notary

Printed Name of Notary

My Commission Expires (mm,dd,yyyy)

County of Residence

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⇓ Indiana Paternity Affidavit 44780 PDF Form

Form Overview

Fact	Detail
Form Name	Indiana Paternity Affidavit 44780
Purpose	To legally establish paternity for a child born out of wedlock in Indiana.
Governing Law(s)	Indiana Code 16-37-2-2.1
Who Must Sign	Both the biological mother and the father wishing to establish paternity.
Where to File	With the local health department in the county where the child was born or the Indiana State Department of Health.
Notarization Required	Yes, signatures of both parents need to be notarized.
Benefits	Establishes legal fatherhood, enabling the child to have access to benefits such as health insurance, social security, and inheritance rights from the father.
Potential Consequences of Not Filing	Child may not have a legal father listed on the birth certificate, may lack access to certain benefits from the father, and the father may not have legal rights to the child.

Guide to Filling Out Indiana Paternity Affidavit 44780

Filing out the Indiana Paternity Affidavit Form 44780 is a necessary step for parents who wish to officially establish the paternity of a child. This is a key document that must be completed carefully to ensure that all legal aspects of paternity are correctly recorded. The completion of this form marks the beginning of formal recognition of a father's relationship with his child. It's important to approach this process with attention to detail, as it impacts legal rights, responsibilities, and the child's wellbeing.

Here are the steps needed to fill out the Indiana Paternity Affidavit Form 44780:

Start by downloading the most current version of the form from the Indiana State Department of Health website or obtain a copy from the hospital or health facility.
Read through the entire form before filling it out to understand the information and declarations you will need to provide.
Fill in the child's information, including full name, place of birth, and date of birth, in the designated sections.
Enter the mother's full name, address, Social Security number, and date of birth in the appropriate fields.
Provide the father's full name, address, Social Security number, and date of birth as requested on the form.
Answer questions related to the father's acknowledgment of paternity, ensuring to read each statement carefully and provide honest responses.
Both parents must sign and date the affidavit in the presence of a notary public or authorized hospital personnel. Ensure the form is also notarized, which verifies the identities of those signing the document.
Review the affidavit to make sure all information is correct and all necessary fields have been filled out. Mistakes may lead to delays in processing or even the need to complete a new form.
Submit the completed and notarized form as directed. This may involve giving it to hospital staff before discharge, mailing it to the address provided on the form, or submitting it to the local health department.

After submitting the form, it will be processed, which is crucial for establishing legal paternity. This official recognition is important for a variety of reasons, including the child's right to support from both parents, access to medical history, and eligibility for benefits. Parents might also seek legal advice to fully understand their rights and responsibilities following the filing of a paternity affidavit. Remember, establishing paternity is a significant step that lays the groundwork for the child's future, impacting many aspects of their life.

Frequently Asked Questions

What is the Indiana Paternity Affidavit 44780 form?

The Indiana Paternity Affidavit 44780 form is a legal document used in the state of Indiana for the purpose of establishing paternity for a child born out of wedlock. This affidavit allows the father of the child to acknowledge paternity voluntarily, thereby granting him legal rights and responsibilities to the child, including custody, visitation, and support obligations.

When should the Indiana Paternity Affidavit 44780 form be filed?

This form should be completed and filed as soon as possible after the child's birth. In Indiana, it is often completed at the hospital shortly after the child is born. The process allows for the father's name to be added to the birth certificate from the outset. However, it can also be completed after leaving the hospital, but the sooner it is done, the easier it is to ensure that the father's rights and responsibilities are established.

Who can sign the Indiana Paternity Affidavit 44780 form?

Both biological parents of the child must sign the Indiana Paternity Affidavit 44780 form for it to be valid. This mutual agreement confirms that both parties acknowledge the man signing the affidavit as the biological father of the child. Their signatures must be notarized to confirm the identity of the signers and the voluntariness of their acknowledgment.

Can the Indiana Paternity Affidavit 44780 form be rescinded?

Yes, there is a brief period during which the affidavit can be rescinded, typically within 60 days from the date it was filed. To rescind the agreement, either parent must file a rescission form with the Indiana State Department of Health. After the 60-day period, challenging the affidavit's validity becomes significantly more difficult and typically requires a court order, often necessitating proof of fraud or a substantial mistake of fact.

What implications does signing the form have for the father?

Signing the Indiana Paternity Affidavit 44780 form has significant long-term implications for the father. It establishes his legal paternity and binds him to all associated rights and responsibilities, including child support, custody, and visitation rights. Additionally, the father gains the legal standing to participate in decisions affecting the child's welfare.

Are there any costs associated with filing the Indiana Paternity Affidavit 44780 form?

Typically, there is no fee to file the Indiana Paternity Affidavit 44780 form at the hospital at the time of the child's birth. However, if the affidavit is filed later on or if additional legal assistance is sought to complete the process, there may be associated costs. It is recommended to check with the local health department or a legal professional for the most current information regarding any potential fees.

What happens if the parents cannot agree on signing the affidavit?

If the parents cannot agree to sign the Indiana Paternity Affidavit 44780 form, the issue of paternity must be resolved through legal channels. This typically involves filing a petition with the court to establish paternity, which may include genetic testing to determine the biological father of the child. The court process can be longer and more complex than voluntarily acknowledging paternity through the affidavit.

Common mistakes

Filling out the Indiana Paternity Affidavit 44780 is a significant step in establishing legal paternity, which bears crucial implications for parental rights, child support, and the child’s access to family medical history, among other things. However, in the process of completing this form, people often make mistakes, some of which can have long-term impacts. Here are six common errors to watch out for:

Not reading the instructions carefully. Many individuals rush through the form without fully understanding the requirements or the implications of what they are signing. This oversight can lead to incorrect or incomplete information, potentially invalidating the affidavit.
Skipping sections. It's not uncommon for people to overlook certain sections or assume they do not apply to them. Every section of the 44780 form is crucial for accurately establishing paternity, and missing information can delay the process.
Providing inaccurate information. Whether unintentional or not, inputting false information can have serious legal ramifications. This mistake often happens with dates (such as the child’s birth date or the date of conception) and personal details.
Failure to have the affidavit notarized. The 44780 form typically requires notarization to verify the identity of the signatories and the authenticity of their signatures. Neglecting this step can render the affidavit invalid.
Not understanding the legal implications. Some individuals sign the affidavit without fully grasping how it affects parental rights, child support obligations, and the legal relationship between the parent and the child. This lack of understanding can lead to decisions that individuals might later regret.
Delay in submitting the form. Waiting too long to submit the paternity affidavit can complicate the legal establishment of paternity, potentially affecting custody, visitation rights, and child support arrangements. Timeliness is key.

To mitigate these mistakes, here are a few practical tips:

Take your time: Carefully read and understand each section before filling out the form.
Verify your information: Double-check all entries for accuracy, especially personal identification information and dates.
Consult with a professional: If there’s any confusion or uncertainty, seeking advice from a legal expert can provide clarity and ensure the process is completed correctly.
Understand the legal consequences: Be fully aware of what signing the affidavit means for you, the child, and the other parent, both now and in the future.
Don’t delay: Complete and submit the form in a timely manner to avoid any unnecessary complications or delays in establishing paternity.

In summary, while the Indiana Paternity Affidavit 44780 form is a critical document in establishing paternity, care should be taken to avoid common errors. By following the guidelines provided and seeking appropriate advice when needed, one can navigate this process more smoothly, ensuring the best outcome for all parties involved.

Documents used along the form

When establishing paternity in Indiana, the Paternity Affidavit 44780 form is a critical document. However, it's usually not the only paperwork needed in the process. The purpose of these additional forms and documents is to support the affidavit, provide evidence, and ensure all legal aspects of paternity establishment are addressed. Here's a list of other forms and documents often used along with the Indiana Paternity Affidavit 44780 form.

Birth Certificate Application: Following the establishment of paternity, it's necessary to apply for a new or updated birth certificate for the child that reflects the father's information.
Child Support Modification Forms: In cases where paternity establishment leads to a child support order, these forms are needed to either initiate or modify the child support arrangements based on the newly established paternity.
Voluntary Acknowledgment of Paternity (VAP): This document is often used in conjunction with the Paternity Affidavit by parents who are not married but agree on the father's identity. It's a voluntary agreement that establishes legal paternity.
Order for Genetic Testing: When paternity is disputed, the court may order genetic testing. This document outlines the court's order for the child, the presumed father, and sometimes the mother to undergo genetic tests.
Custody and Visitation Agreements: Establishing paternity can lead to the need for formalizing custody and visitation. These documents outline the arrangements agreed upon by the parents or ordered by the court.
Income Verification Forms: These are used to verify the income of the alleged father and/or the mother for the purpose of determining child support obligations following the establishment of paternity.

Collectively, these documents, along with the Indiana Paternity Affidavit 44780, complete the legal framework necessary for establishing paternity. They ensure the child's rights are protected, and the legal obligations of the parents are clearly defined. Understanding and completing these documents accurately is crucial for the wellbeing of all parties involved.

Similar forms

The Indiana Paternity Affidavit 44780 form is similar to other documents used to establish or disavow paternity, as well as to documents related to parental rights and child support. While the content of these forms can vary by state, they typically share the purpose of legally recognizing the relationship between a parent and a child. This form, in particular, is crucial for unmarried parents to establish paternity, which can then affect child support, custody, and visitation rights. The similarities among these documents often lie in their legal implications and the need for accurate, truthful information.

The Voluntary Acknowledgment of Paternity

This form, used across various states, is quite similar to the Indiana Paternity Affidavit 44780 in its primary function. Both serve to legally establish the paternity of a child, usually at the hospital right after the child's birth or at a later time through a state health department or court. They require both parents' consent and carry significant legal weight, ensuring the father's name is added to the birth certificate. This acknowledgment is pivotal for the father's rights to custody and visitation, as well as for the child's rights to support and inheritance.

Child Support Enforcement Forms

Though not identical, the Indiana Paternity Affidavit is closely related to child support enforcement forms. These forms are part of the process to secure financial support for a child from the non-custodial parent. Establishing paternity is often a prerequisite for child support proceedings, making the paternity affidavit an essential document. The connection between them highlights the legal system's commitment to the welfare and support of children, ensuring they receive the financial support entitlement from both parents.

Custody and Visitation Forms

Custody and visitation forms are another set of documents that share a correlation with the Indiana Paternity Affidavit 44780 form. Establishing paternity is a fundamental step before a father can seek custody rights or visitation schedules through the court. These forms outline the arrangements for where and with whom the child will live, as well as how often and under what conditions the other parent will visit the child. The affidavit thus acts as a stepping stone for unmarried fathers to assert their rights and responsibilities regarding their children.

Dos and Don'ts

When filling out the Indiana Paternity Affidavit 44780 form, understanding the dos and don’ts can significantly affect the process and outcome. Here's a guide to help you navigate through correctly and effectively.

Do thoroughly read the entire form before filling it out. Understanding every section ensures that you know what information is required.
Do use black ink for clarity and legibility. The form must be readable by all parties involved, including legal authorities.
Do provide accurate information. Every piece of information you provide should be truthful and as accurate as possible to avoid legal complications.
Do ask for clarification if there’s anything you don’t understand. It’s better to seek advice than to make an incorrect assumption.
Do review the form for any mistakes or typos before submitting it. A quick review can catch errors that might complicate or delay the process.
Don’t leave any sections blank unless instructed. If a section does not apply, consider entering “N/A” (not applicable) to indicate that you didn’t overlook it.
Don’t rush through the form. Take your time to ensure that all information is complete and accurate.
Don’t use pencil or colors other than black ink. This prevents alterations and ensures the form is official and archival.
Don’t sign the affidavit until you are in the presence of a notary public or the designated official, as your signature may need to be witnessed or notarized.

By following these guidelines, you'll help ensure that the process goes smoothly and that your Paternity Affidavit is filled out correctly, minimizing delays and complications.

Misconceptions

Understanding the intricacies of legal documents is key to ensuring rights and responsibilities are clearly recognized. When it comes to the Indiana Paternity Affidavit 44780 form, several misconceptions can lead to confusion and unintended consequences. Here are four common misunderstandings:

Signing it is required by all parents. Many people believe that every new parent must sign the Paternity Affidavit 44780 form in Indiana. In reality, this form is specifically designed for situations where parents are not married to each other at the child's birth. Its purpose is to establish the legal paternity of the child.
It only benefits the mother. There's a misconception that this affidavit is solely in the mother's interest, often to secure child support. While establishing paternity does play a significant role in arranging child support, it also benefits the father and the child. For the father, it grants legal recognition and rights concerning the child. For the child, it ensures access to rights like inheritance, access to medical histories, and potential benefits such as insurance and social security from both parents.
There's no way to revoke it once signed. Some believe that once the Paternity Affidavit is signed, the decision is irreversible. However, there is a rescission period during which the signatory can reverse the declaration. In Indiana, this period is limited to 60 days from the date the affidavit is signed or the date of a court order related to the child, whichever comes first. After this period, challenging the affidavit's validity becomes significantly more complicated and requires legal proceedings.
Legal advice is not necessary. Finally, a common misunderstanding is that you don't need legal advice to complete the Paternity Affidavit 44780 form. Given the form’s long-term legal implications, consulting with a legal professional before signing is advisable. They can provide clarity on rights, responsibilities, and potential future implications, helping parents make informed decisions.

Dispelling these misconceptions is crucial for parents to navigate their responsibilities and rights properly. Understanding the purpose and implications of the Indiana Paternity Affidavit 44780 form ensures that all parties involved make informed decisions that align with their best interests and those of their child.

Key takeaways

The Indiana Paternity Affidavit 44780 form is a critical document for establishing paternity in the State of Indiana. It allows parents to acknowledge paternity voluntarily, ensuring the child's right to benefits such as child support, Social Security, and health insurance. Here are the key takeaways to understand when filling out and using this form:

Completeness is crucial: Ensure all sections of the form are filled out completely and accurately. Missing information can delay the process or render the affidavit invalid.
Sign in the presence of a notary: Both parents must sign the form in the presence of a notary public to verify their identities and the voluntariness of their acknowledgment.
Understand the implications: By signing the affidavit, both parents agree to the legal determination of paternity. This includes responsibilities such as child support and rights regarding the child’s upbringing.
There’s a revocation period: Keep in mind there's a limited time after signing when either parent can revoke their acknowledgment, typically within 60 days unless a court order states otherwise.
File promptly: Once signed and notarized, submit the affidavit to the appropriate Indiana State department promptly to avoid delays in its recognition.
Accuracy is key: Double-check the information for accuracy before submitting. Incorrect information can complicate legal matters or require a new affidavit to be completed.
No fees required: There is no fee to file the affidavit with the state, making it an accessible option for parents to establish paternity.
Confidentiality: The information provided in the affidavit is confidential and protected under law, accessible only by authorized individuals or entities.
Legal advice can help: Consider consulting with a lawyer if you have questions or concerns about the legal implications of signing the affidavit. Professional advice can provide clarity and peace of mind.

Filling out the Indiana Paternity Affidavit accurately and understanding its importance lays the foundation for the child's legal and financial rights. It's a significant step towards ensuring the well-being and support of the child throughout their life.

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