INSTRUCTIONS FOR COMPLETING THE DENIAL OF PATERNITY PURPOSE: This form is completed by the mother and her husband/exhusband to declare that he is not the father of a child, when a mother has named another man as the biological father. PLEASE READ ALL PARTS OF THIS FORM, INCLUDING THE INFORMATION ABOUT YOUR RIGHTS AND RESPONSIBILITIES BEFORE COMPLETING IT. 1. The Denial of Paternity form may not be signed before the child is born. The form may be signed for any child under the age of twenty-one. Only the English version of the form is legal. Do not complete, sign or send a Spanish language form. The Spanish language form is used for translation purposes only. 2. Print all information except your signature. Use a black ink ballpoint pen and press hard. 3. Fill in all the spaces. If you cannot answer, please write “Don’t Know” or put a dash (-). 4. Each person must sign in front of an adult witness. A witness may be any adult age eighteen or older other than the child or parents named on the Voluntary Acknowledgment of Paternity or Denial of Paternity form(s). 5. If you are completing the form at the hospital when the baby is born, the staff will add the biological father’s name to the birth certificate, mail the correct copies for you and give you your copies. The third copy is for the mother of the child and the fourth copy is for the husband/exhusband. A photocopy may be made to give to the biological father. 6. If the mother of the child named on this Denial of Paternity was married at the time of conception or upon the birth of the child, and the husband/exhusband is not the biological father, the husband/exhusband and the mother must sign the Denial of Paternity form and the mother and biological father must sign the Voluntary Acknowledgment of Patnerity form. If the husband/exhusband and mother do not sign the Denial of Paternity or the mother and the biological father do not sign the Voluntary Acknowledgment of Paternity, the husband/exhusband by law is presumed to be the father of the child and his name must be placed on the birth certificate. 7. If you complete this form after you leave the hospital, sign in front of an adult witness. Send the original and second copy to: ADMINISTRATIVE COORDINATION UNIT DPA 3416D DIVISION OF CHILD SUPPORT ENFORCEMENT ILLINOIS DEPARTMENT OF PUBLIC AID 509 SOUTH SIXTH STREET SPRINGFIELD, ILLINOIS 62701-1825 Voluntary Acknowledgment of Paternity and the Denial of Paternity forms are available by writing or going to the Illinois Department of Public Health, Illinois Department of Human Services, State or local registrars, county clerks or any Illinois Department of Public Aid, Division of Child Support Enforcement office. For more information call the Child Support Help Line at 1-800-447-4278. For more information about completing the Voluntary Acknowledgment of Paternity or the Denial of Paternity form, read the informational flyer, “Two Parents…Give Your Child HOPE”. NOTICE OF RIGHTS AND RESPONSIBILITIES 1. When the husband/exhusband and mother sign the Denial of Paternity form, and the mother and biological father sign the Voluntary Acknowledgment of Paternity form the biological father becomes the legal father of the child for all purposes and the husband/exhusband waives his legal rights and responsibilities to the child. 2. The husband/exhusband has the right to genetic testing on the issue of paternity. By signing the Denial of Paternity he is waiving these rights. 3. The Voluntary Acknowledgment of Paternity may be rescinded (withdrawn) within 60 days of the signing of the Voluntary Acknowledgment of Paternity or an administrative or judicial proceeding whichever comes first. If either party signs the Rescission of Voluntary Acknowledgment of Paternity the denial has no legal affect and you are legally responsible for the support of the child. 4. If you want legal advice you should talk to an attorney. You have the right to an attorney, a hearing and a right to have genetic testing. 5. You may call the Illinois Department of Public Aid, Division of Child Support Enforcement, at 1-800-447-4278 if you have questions regarding the Voluntary Acknowledgment of Paternity or the Denial of Paternity. Persons using a teletypewriter (TTY) may call 1-800-526- 5812.
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