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8.D CSE Affidavit Acknowledging Paternity Form


Appendix 8.D – CSE Affidavit Acknowledging Paternity Form

Purpose:
Form used to track number of affidavits completed in District CSE Offices.

Form:

Below is an example of the excel spreadsheet used by the District CSE Offices.

 
Mother's Name		 
Alleged Father's Name		 Presumed Father's Name 
Date(s) Signed		 Date Sent to Vital Records # of Children w/Paternity Established
 Minnie MouseMickey Mouse   12/26/200312/26/2003  4
 Daisy DuckRoad Runner  Donald Duck12/26/2003 12/26/2003 1 
Sponge Bob  Dora the Explorer   12/26/200312/26/2003  18
      
      
 TOTAL PATERNITIES ESTABLISHED23