Provide your Information

Name:
Address:
City:    County:
State: Zip:
Phone Number:
Alternate Number:
Email:
Social Security #:

Provide the Mother's Information (We will not contact the mother)

Name:
Address:
City:    County:
State: Zip:
Location of Conception:
Mother's Marital Status at Time of Conception:Select OneSingleMarried
If married, indicate whether you were the spouse:Select OneYesNo

Provide the Child's Information

Name:
Date of Birth:
Location of Birth (City, State):

Indicate whether the child resides with the mother: Select OneYesNo

If not, indicate the name and address of the person with physical custody:
County of Child's Residence:


Provide Prior Court Action Information

Indicate whether there have been prior actions between the parties.


Indicate whether DNA testing has been performed (If not, DNA testing will be requested): Select OneYesNo

If yes, indicate the name of the company which performed the test and the date  on which the test was performed:

Indicate whether an Affidavit of Parentage has been signed by both parents: Select OneYesNo

Indicate whether you are named on the child's birth certificate: Select OneYesNo

 ACKNOWLEDGMENT: Speedy Legal Docs did not provide me with any advice, explanation or representation about any legal rights, remedies, defenses or options.