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Required Data Elements for Paternity Acknowledgement Affidavits


Published: January 23, 1998


January 23, 1998


SUBJECT: Required Data Elements for Paternity Acknowledgement Affidavits

REFERENCES: Sections 452(a)(7) and 466(a)(5)(C)(iv) of the Social Security Act as added by section 331 the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104-193)

PURPOSE: Section 452(a)(7) of the Social Security Act (the Act) as amended by section 331 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) requires the Secretary of the Department of Health and Human Services to specify the minimum requirements of an affidavit to be used for the voluntary acknowledgment of paternity which shall include the social security number of each parent. In addition, section 466(a)(5)(C)(iv) of the Act as amended by section 331 of PRWORA requires States to enact laws requiring the development and use of an affidavit for the voluntary acknowledgement of paternity which includes the minimum requirements of the affidavit specified by the Secretary and to give full faith and credit to such an affidavit signed in any other State according to its procedures.

This action transmittal establishes the minimum data elements and information requirements that must be included in all State paternity acknowledgment affidavits.

BACKGROUND: In 1996, the Department of Health and Human Services established a task group composed of Federal and State staff to recommend minimum data elements and information requirements for all State paternity acknowledgement affidavits. Federal staff were drawn from the Office of Child Support Enforcement's central and regional offices and from the Federal Vital Statistics agency and State staff from several State Child Support agencies and one State Vital Statistics agency. We also sought input from advocacy groups. The task group completed its work in the spring of 1997.

Throughout their deliberation process, the task group sought to balance the need for a paternity acknowledgement affidavit that could serve as a tool for collecting important information that could be used in the establishment of a child support order at a future date, and the need for a form that is user-friendly and addresses only the basic data elements necessary to establish legal paternity.

The task group studied affidavits or acknowledgment of paternity forms from every State to identify information requirements commonly used by the majority of States. They classified data elements as either required or optional, always taking into consideration the very real possibility that an overly-prescriptive paternity acknowledgement affidavit could actually discourage parents from signing the form.

In addition, we published the proposed data elements in the Federal Register (62 FR 39246) requesting comments on the proposed minimum data elements as well as information collection activities to comply with the requirements of section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995. A second notice requesting comments was published in the Federal Register (62 FR 61512).

Required Data Elements

Based on the work of the task group and the comments received in response to the Federal Register notice, the following data elements are the minimum requirements of a paternity acknowledgement affidavit:

  • Current full name of mother, father and child;
  • Social security number of mother and father;
  • Date of birth of mother, father and child;
  • Address of mother and father;
  • Birthplace of child;
  • A brief explanation of the legal significance of signing a voluntary paternity affidavit and a statement that both parents have 60 days to rescind the paternity acknowledgement affidavit;
  • A clear statement signed by both parents indicating they understand that signing the paternity acknowledgement affidavit is voluntary and that they understand what their rights, responsibilities, alternatives and consequences are;
  • Signature lines for mother and father; and
  • Signature lines for witnesses or notaries.

Optional Data Elements

The task group felt that some other items were also important and that these items should be optional for a State to include. Among the optional data elements are some that the task group felt should be strongly recommended. These include:

  • Sex of child: This information would aid in identification of the child;
  • Father's Employer; and
  • Maiden Name of Mother.

The complete list of required and optional data elements appears in Appendix A. Of course, a State is free to include additional items in its voluntary acknowledgment of paternity affidavit.

The Office of Management and Budget has reviewed and approved this information collection and has assigned it Control Number 0970-0171.

INQUIRIES: Inquiries should be directed to the appropriate Administration for Children and Families (ACF) Regional Administrator.

David Gray Ross
Deputy Director
Office of Child Support

Appendix A


Table 1: Complete List of Required and Options Data Elements

1. Current Full Name
(mother, father and child)

1. Daytime Phone Number
(mother and father)

2. Social Security Number
(mother and father)

2. Birthplace - mother and father
(city, county & state)

3. Date of Birth
(mother, father and child)

3. Hospital of Birth

4. Address
(mother and father)

4. Sex of Child

6. Birthplace - child
(city, county & state)

5. Father's Employer

7. Legal Finding (60 day recision)

6. Ethnicity of Father

8. Rights and Responsibilities, Alternatives and Consequences

7. Medical Insurance

9. Signature Lines for Parents

8. Maiden Name of Mother

10. Notary Seals/Witnesses: Signature Lines

9. Place Where Acknowledgment or Affidavit Was Completed


10. Offer of Name Change


11. Minors: Signature Line for Guardian Ad Litem or Legal Guardian


12. Three-Way Signature Offered on Form
(husband, wife, and biological father)


13. An advisory to parents that they may wish to seek legal counsel or obtain a genetic test before signing


14. A statement concerning the custody status of the child vis-a-vis State law

OMB Control Number: 0970-0171

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