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Request for a Certified Copy of Acknowledgment of Paternity

HS_21.pdf

Form Instructions

INSTRUCTIONS: ALABAMA REQUEST FOR CERTIFIED COPY OF ACKNOWLEDGMENT OF PATERNITY (Form ADPH-HS-21)

To request an Alabama certified copy of acknowledgment of paternity, a form ADPH-HS-21 should be submitted. This document can be obtained from the website of the Alabama Department of Public Health.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 1: Enter the number of copies you are requesting on the first blank line.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 2: Enter the fee being paid on the second blank line. The first copy will cost $15, with an additional $6 charged for each additional copy.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 3: Enter the full name of the child documented on the acknowledgment of paternity on the third blank line.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 4: Enter the child's date of birth on the fourth blank line.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 5: Enter the child's sex on the fifth blank line.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 6: Enter the child's county of birth on the sixth blank line.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 7: Enter the child's hospital of birth on the seventh blank line.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 8: Enter the full maiden name of the mother on the eighth blank line.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 9: Enter the full name of the father on the ninth blank line.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 10: The applicant should enter their signature on the tenth blank line and the date on the eleventh blank line.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 11: Print your name on the twelfth blank line and enter your daytime phone number on the thirteenth blank line.

Alabama Request For Certified Copy Of Acknowledgment Of Paternity ADPH-HS-21 Step 12: Enter your address, city, state and zip code on the next four blank lines. Enter your relationship to the person whose record is being requested on the next blank line, and the reason for your request if not an immediate family member on the last blank line.

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