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Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Paternity Information

Acknowledgment of Paternity Affidavits executed in the hospital at the time of birth are submitted to the Vital Records Registry with the birth record by hospital staff. They are processed and filed without charge. Your child's birth certificate will reflect the name and paternity information shown on the Affidavit.

Acknowledgment of Paternity Affidavits executed following your child's birth certificate being registered with Vital Records require special processing at the Vital Records Central Office and statutory fees must be submitted.

You must submit the appropriate completed form to Vital Records with your child's certified birth certificate along with a fee of $27.50. This fee includes one certified copy of the child's amended birth certificate. At the time of submission, you may also include $9.00 for each additional certified copy you would like to recieve. If you do not submit a certified copy of your child's birth certificate, include an additional $15 statutory search fee.

Acknowledgment of Paternity Affidavits are legal documents. Adhere to all instructions provided. Carefully read and initial the Alternatives, Rights and Responsibilities page.

Acknowledgment of Paternity: Child Born Outside of Marriage

This Acknowledgment of Paternity Affidavit is used to add the biological father to a child's birth certificate if the mother was not married at the time of birth or within 300 days of the birth.

If an Acknowledgment of Paternity Affidavit was completed for this child in the past and there is already a father listed on the child's birth certificate, DO NOT COMPLETE THIS FORM.

If the mother was married to someone other than the biological father when she became pregnant or anytime during the pregnancy, DO NOT COMPLETE THIS FORM (See Acknowledgment of Paternity: Child Born of Marriage).

Read the following instructions carefully before completing the form:

  • The Acknowledgment of Paternity Affidavit may not be signed before your child is born.
  • This is a legal document. Type or complete the form in black ink. Do not alter the form, use liquid paper, or make any scratch outs. Forms that have been altered will be rejected.
  • Complete each item on the form. List your current insurance coverage even if it did not cover the hospital bill for your child's birth. If you do not have insurance, write "None".
  • You must list your Social Security Number on the form. If you do not have a Social Security Number, write "None".
  • Both parents must sign this form with two witnesses in the presence of a licensed notary. DO NOT SIGN THIS FORM BEFORE YOU HAVE IT NOTARIZED. Show the notary your picture identification. The notary must write or stamp their State Notary ID Number under their signature.
  • If you would like to change your child's last name, you must list the name as you want it to appear on the birth certificate in the Child's Information Section of the form. You will not be able to change your child's last name on the birth certificate without a Louisiana court order after we receive and process the form.
  • This Acknowledgment of Paternity Affidavit may be signed for any child who was born in Louisiana. It can be mailed to a parent anywhere to be signed in the presence of a licensed notary.

For an Acknowledgment of Paternity: Child Born Outside of Marriage, click here.

Acknowledgment of Paternity: Child Born Of Marriage

This Acknowledgment of Paternity Affidavit is used to add the biological father to a child's birth certificate if the mother was married to someone other than the biological father at the time of the child's birth or if she had not been divorced at least 300 days prior to the child's birth.

This form requires the notarized signatures of the mother, the husband/ex-husband, and the biological father.

Read the following instructions carefully before completing the form:

  • The Acknowledgment of Paternity Affidavit may not be signed before your child is born.
  • This is a legal document. Type or complete the form in black ink. Do not alter the form, use liquid paper, or make any scratch outs. Forms that have been altered will be rejected.
  • Complete each item on the form. List your current insurance coverage even if it did not cover the hospital bill for your child's birth. If you do not have insurance, write "None".
  • You must list your Social Security Number on the form. If you do not have a Social Security Number, write "None".
  • The mother's husband/ex-husband's name and address must be listed in the Mother's Information Section.
  • All three parties must sign this form with two witnesses in the presence of a licensed notary. DO NOT SIGN THIS FORM BEFORE YOU HAVE IT NOTARIZED. Show the notary your picture identification. The notary must write or stamp their State Notary ID Number under their signature.
  • If you would like to change your child's last name, you must list the name as you want it to appear on the birth certificate in the Child's Information Section of the form. You will not be able to change your child's last name on the birth certificate without a Louisiana court order after we receive and process the form.
  • This Acknowledgment of Paternity Affidavit may be signed for any child who was born in Louisiana. It can be mailed to a parent anywhere to be signed in the presence of a licensed notary.

For an Acknowledgment of Paternity: Child Born of Marriage, click here.

Revocation of Acknowledgment of Paternity within 60-Days

Any person signing an Acknowledgment of Paternity may, without cause, revoke their acknowledgment within 60-days of executing (signing) the form. The person must complete a Revocation of Acknowledgment of Paternity Affidavit and file it with Vital Records within the 60-day period.

Read the following instructions carefully before completing the form:

  • This is a legal document. Read all instructions carefully and complete the entire form.
  • The form may be executed by any person who signed or concurred on the Acknowledgment of Paternity which is desired to be revoked.
  • The form must be notarized by a notary public and witnessed by two competent witnesses.
  • The form must be filed with the Louisiana Vital Records Registry Central Office within 60-days of the date of execution of the authentic act of acknowledgment.
  • If the acknowledging father was served with a Department of Children and Family Services (DCFS) Petition for Support for the child who is the subject of the act, the State Registrar will send a copy of the executed and filed Revocation of Acknowledgment of Paternity to DCFS.
  • If the acknowledging father is not involved in DCFS child support proceedings, the State Registrar shall not forward the executed and filed Revocation of Acknowledgment of Paternity to DCFS as the revocation instrument would be deemed confidential pursuant to LSA R.S. 40:41.
  • A statutory fee of $27.50 must be sent to the Vital Records Registry along with the revocation form.
  • The submission of the statutory fee and the completed and notarized Revocation of Acknowledgment form will result in (1) the rescission of the Acknowledgment of Paternity on file with the Vital Records Registry; (2) the acknowledging father's name being removed from the original birth certificate of the child; and (3) the child's surname being changed to the mother's maiden name.

For a Revocation of Acknowledgment of Paternity Affidavit, click here.

 


If you have any questions or additional information regarding the completion of these forms, contact the Vital Records Services Section at (504) 593-5122.

Mail the completed forms and fees to:
Louisiana Vital Records
ATTN: Amendment Department
P.O. Box 60630
New Orleans, LA  70160