Form JFS07038 "Acknowledgment of Paternity Affidavit" - Ohio

What Is Form JFS07038?

This is a legal form that was released by the Ohio Department of Job and Family Services - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2014;
  • The latest edition provided by the Ohio Department of Job and Family Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form JFS07038 by clicking the link below or browse more documents and templates provided by the Ohio Department of Job and Family Services.

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Download Form JFS07038 "Acknowledgment of Paternity Affidavit" - Ohio

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Ohio Department of Job and Family Services
ACKNOWLEDGMENT OF PATERNITY AFFIDAVIT
Ohio Revised Code Section 3111.31
(Please read the important information on this page before completing the affidavit on the reverse side)
Notice of Rights and Responsibilities and Due Process Safeguards
Completion of the Acknowledgment of Paternity affidavit is voluntary.
If a man voluntarily acknowledges a parent and child relationship by signing an acknowledgment of paternity affidavit
(hereafter paternity affidavit), he assumes the parental duty of support which may be enforced through a child support order.
Both parents who sign this paternity affidavit waive any right to bring a court action to establish paternity pursuant to sections
3111.01 to 3111.18 of the Revised Code or make a request for an administrative determination of a parent and child relationship
pursuant to section 3111.38 of the Revised Code, other than a court action filed for purposes of rescinding the paternity
affidavit.
There are some circumstances set forth in state law under which either parent may rescind the paternity affidavit after it is
signed (pursuant to sections 3111.27, 3111.28, and 3119.961 of the Revised Code). To rescind the paternity affidavit, no later
than 60 days after the date of the latest signature on the acknowledgment of paternity affidavit, either parent who signed it must
do both of the following:
1.
Request an administrative determination of a parent and child relationship from the county child support enforcement
agency in which the child, guardian or legal custodian of the child resides and
2.
Send a written notice to the Central Paternity Registry to the address below that you have requested an administrative
determination of a parent and child relationship, and include in the notice the name of the child support enforcement
agency conducting the genetic tests.
After the 60 day period and within one year after the paternity affidavit becomes final pursuant to sections 2151.232, 3111.25 or
3111.821 of the Revised Code, either parent who signed the paternity affidavit or the alleged father may file an action with the
court to rescind the paternity affidavit on the basis of fraud, duress, or material mistake of fact.
A man who is determined to be the father of a child has the right to petition a court for an order granting him reasonable
parenting time with respect to the child (pursuant to section 3109.12 of the Revised Code) and petition the court for custody of
the child (pursuant to section 2151.23 of the Revised Code). Pursuant to section 3109.042, an unmarried female who gives birth
to a child is the sole residential parent and legal custodian of the child until a court issues an order designating another person
as the residential parent and legal custodian. The court will treat the mother and father on an equal standing when making this
designation.
If a child, a man, a child's mother, or a person who represents them is not sure if the man is the child's father, paternity may be
established through genetic testing. Testing can be arranged, usually without charge, through the child support enforcement
agency (CSEA) if a court or an administrative action to establish paternity is filed. If testing is desired, do not sign the paternity
affidavit but instead contact the local CSEA and request genetic tests. If the test shows that a man is the father, the agency will
then issue an administrative order establishing paternity and may proceed to determine a child support order.
Purpose of this Affidavit
The purpose of the paternity affidavit on the other side of this form is to acknowledge the legal existence of a father and child relationship
through voluntary paternity establishment.
This paternity affidavit cannot be signed if another man is presumed to be the natural father of the child. Pursuant to Ohio
Revised Code section 3111.03, a man is presumed to be the natural father of a child in the following circumstances:
1.
A man is married to the child's mother at the time of the child's birth; or
2.
A man and the child's mother were married to each other and the child is born within 300 days after the marriage is ended by
court order or by the death of the man or the mother; or
3.
A man and the child's mother were married to each other and the child is born after the man and the child's mother file a
separation agreement in court; or
4.
A man signed an Acknowledgment of Paternity Affidavit which has been filed with the Ohio Department of Job & Family
Services and the Acknowledgment has not become final.
A legal father and child relationship can also be established through a court or administrative order.
Instructions
* Type or print legibly in dark blue or black ink.
* All required spaces in the child's, mother's, and father's sections must be filled out.
* Both the natural father and mother of the child are required to sign this affidavit. The affidavit may be signed without being in each
other’s presence. However, each parent's signature must be notarized at the time of signing by either the same notary public or different
ones.
* After the affidavit has been completed, signed, and notarized, it must be sent within 10 calendar days of the last signature to the
following address:
Central Paternity Registry
PO Box 183206
Columbus, OH 43218-3206
* You can contact the Central Paternity Registry if you have any questions toll free at 1-888-810-6446.
JFS 07038 (Rev. 5/2014)
Page 1 of 2
Ohio Department of Job and Family Services
ACKNOWLEDGMENT OF PATERNITY AFFIDAVIT
Ohio Revised Code Section 3111.31
(Please read the important information on this page before completing the affidavit on the reverse side)
Notice of Rights and Responsibilities and Due Process Safeguards
Completion of the Acknowledgment of Paternity affidavit is voluntary.
If a man voluntarily acknowledges a parent and child relationship by signing an acknowledgment of paternity affidavit
(hereafter paternity affidavit), he assumes the parental duty of support which may be enforced through a child support order.
Both parents who sign this paternity affidavit waive any right to bring a court action to establish paternity pursuant to sections
3111.01 to 3111.18 of the Revised Code or make a request for an administrative determination of a parent and child relationship
pursuant to section 3111.38 of the Revised Code, other than a court action filed for purposes of rescinding the paternity
affidavit.
There are some circumstances set forth in state law under which either parent may rescind the paternity affidavit after it is
signed (pursuant to sections 3111.27, 3111.28, and 3119.961 of the Revised Code). To rescind the paternity affidavit, no later
than 60 days after the date of the latest signature on the acknowledgment of paternity affidavit, either parent who signed it must
do both of the following:
1.
Request an administrative determination of a parent and child relationship from the county child support enforcement
agency in which the child, guardian or legal custodian of the child resides and
2.
Send a written notice to the Central Paternity Registry to the address below that you have requested an administrative
determination of a parent and child relationship, and include in the notice the name of the child support enforcement
agency conducting the genetic tests.
After the 60 day period and within one year after the paternity affidavit becomes final pursuant to sections 2151.232, 3111.25 or
3111.821 of the Revised Code, either parent who signed the paternity affidavit or the alleged father may file an action with the
court to rescind the paternity affidavit on the basis of fraud, duress, or material mistake of fact.
A man who is determined to be the father of a child has the right to petition a court for an order granting him reasonable
parenting time with respect to the child (pursuant to section 3109.12 of the Revised Code) and petition the court for custody of
the child (pursuant to section 2151.23 of the Revised Code). Pursuant to section 3109.042, an unmarried female who gives birth
to a child is the sole residential parent and legal custodian of the child until a court issues an order designating another person
as the residential parent and legal custodian. The court will treat the mother and father on an equal standing when making this
designation.
If a child, a man, a child's mother, or a person who represents them is not sure if the man is the child's father, paternity may be
established through genetic testing. Testing can be arranged, usually without charge, through the child support enforcement
agency (CSEA) if a court or an administrative action to establish paternity is filed. If testing is desired, do not sign the paternity
affidavit but instead contact the local CSEA and request genetic tests. If the test shows that a man is the father, the agency will
then issue an administrative order establishing paternity and may proceed to determine a child support order.
Purpose of this Affidavit
The purpose of the paternity affidavit on the other side of this form is to acknowledge the legal existence of a father and child relationship
through voluntary paternity establishment.
This paternity affidavit cannot be signed if another man is presumed to be the natural father of the child. Pursuant to Ohio
Revised Code section 3111.03, a man is presumed to be the natural father of a child in the following circumstances:
1.
A man is married to the child's mother at the time of the child's birth; or
2.
A man and the child's mother were married to each other and the child is born within 300 days after the marriage is ended by
court order or by the death of the man or the mother; or
3.
A man and the child's mother were married to each other and the child is born after the man and the child's mother file a
separation agreement in court; or
4.
A man signed an Acknowledgment of Paternity Affidavit which has been filed with the Ohio Department of Job & Family
Services and the Acknowledgment has not become final.
A legal father and child relationship can also be established through a court or administrative order.
Instructions
* Type or print legibly in dark blue or black ink.
* All required spaces in the child's, mother's, and father's sections must be filled out.
* Both the natural father and mother of the child are required to sign this affidavit. The affidavit may be signed without being in each
other’s presence. However, each parent's signature must be notarized at the time of signing by either the same notary public or different
ones.
* After the affidavit has been completed, signed, and notarized, it must be sent within 10 calendar days of the last signature to the
following address:
Central Paternity Registry
PO Box 183206
Columbus, OH 43218-3206
* You can contact the Central Paternity Registry if you have any questions toll free at 1-888-810-6446.
JFS 07038 (Rev. 5/2014)
Page 1 of 2
PLEASE READ THE IMPORTANT INFORMATION ON THE REVERSE SIDE BEFORE COMPLETING THIS PAGE
*Please type or print in dark blue or black ink*
CHILD’S INFORMATION
Name: __________________________________________________________________________________________________
(First)
(Middle)
(Last)
(Suffix, if applicable (i.e. Jr/Sr))
Date of Birth: ____________________________
Place of Birth: __________________________________________
(Mo/Day/Year)
(City)
(State)
(County)
Current Residence: _______________________________________________________________________________________
(Full Street Address)
(City)
(State)
(Zip)
f a birth certificate for the child has already been filed, do you now wish to change the child’s name?
I
YES
NO
If “YES”, give the child’s new name: __________________________________________________________________________
(First)
(Middle)
(Last)
(Suffix, if applicable (i.e. Jr/Sr))
MOTHER’S AFFIRMATION
(Name at the time of child’s birth)
Name: ________________________________________________________________ Maiden Name: ______________________
(First)
(Middle)
(Last)
Address: _________________________________________________________________________________________________
(Full Street Address)
(City)
(State)
(Zip)
Date of Birth: ______________________________
Social Security Number: _________________________________
(Mo/Day/Year)
(If you do not have a SSN enter N/A)
You are required to provide your social security number in accordance with federal law at
42 USC 666, your social security number will be used for child support purposes only.
SIGNATURE AND NOTARIZATION
State of _____________, County of _____________, ss. I state under oath or by affirmation that I have read or had read to me all
information on both sides of this form; that the information I have supplied for this form is true to the best of my knowledge and belief; that
I have received information regarding my legal rights and responsibilities; and that I am the natural mother of the child named on this form
and I assume the parental duty of support of the child.
_______________________________________________________
Signature of the Mother
(Please read page one (1) before signing your name)
(SEAL)
Before me appeared the above named person (mother) who signed this affidavit
under oath or by affirmation on this ________________ day of ________________, in the year ___________.
___________________________________
______________________
Signature of Notary Public
Expiration of Commission
FATHER’S AFFIRMATION
Name: ______________________________________________________________________
(First)
(Middle)
(Last)
(Suffix, if applicable (i.e. Jr/Sr))
Address: _________________________________________________________________________________________________
(Full Street Address)
(City)
(State)
(Zip)
State or: ___________________________________
Country of Birth
Date of Birth: ______________________________
Social Security Number: _________________________________
(Mo/Day/Year)
(If you do not have a SSN enter N/A)
You are required to provide your social security number in accordance with federal law at
42 USC 666, your social security number will be used for child support purposes only.
SIGNATURE AND NOTARIZATION
State of _______________, County of _____________, ss. I state under oath or by affirmation that I have read or had read to me all
information on both sides of this form; that the information I have supplied for this form is true to the best of my knowledge and belief; that
I have received information regarding my legal rights and responsibilities; that I consent to the jurisdiction of the courts of this state; and
that I am the natural father of the child named on this form and I assume the parental duty of support of the child.
___________________________________________________________
Signature of the Father
(Please read page one (1) before signing your name)
(SEAL)
Before me appeared the above named person (father) who signed this affidavit
under oath or by affirmation on this _____________ day of _____________________, in the year ____________.
____________________________________
______________________
Signature of Notary Public
Expiration of Commission
EBC #
CSEA #
Registrar #
CPR #
ODH File #
JFS 07038 (Rev. 5/2014)
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