5-C:25 Informational Requirements for an Affidavit of Paternity. –
I. Parents shall include the following information when completing an affidavit of paternity:
(a) Information about the child including: the child's first, middle, and last names; the child's city or town and state of birth; the child's date of birth; the child's name as it appears on the birth record; the child's social security number, if known; whether the child is living; and, the child's date and place of death, if applicable.
(b) Information about, and signature of, the child's natural father, including: the natural father's full name and date of birth; the natural father's state of birth; the natural father's social security number; the natural father's address; and, the natural father's signature and date signed, unless the natural father is a minor in which case his parent or guardian's signature shall be obtained and the date signed.
(c) Information about, and signature of, the child's mother, including: the mother's maiden name; the mother's social security number; the mother's address; if the mother is a minor, her parent or guardian's signature; and, the mother's signature and date signed, unless the mother is a minor, in which case her parent or guardian's signature shall be obtained and the date signed.
(d) When the mother's husband agrees that he is not the child's natural father, the following information, and signature of, the mother's husband, including: the husband's name; the husband's social security number; the husband's address; and the husband's signature and date signed, unless the husband is a minor in which case his parent or guardian's signature shall be obtained and the date signed.
(e) The signatures of the child's natural father, mother, and, if he is not the child's father, her husband, shall be notarized and shall include the date signed and the date the notary's commission expires.
(f) Certification of hospital or birthing center, including the name and signature of the preparer and date signed, and the name and the address of the hospital or birthing facility.
II. In the case of a home birth, the midwife or attendant shall refer the mother to the clerk of the town or city to complete the affidavit of paternity.