PARENT’S GUIDE TO Acknowledging Parentage in VT

Get helpVermont’s parentage law can be straightforward or complicated, depending on the circumstances. Contact OCS if you need help establishing parentage for the purpose of child support. Phone: 1-800-786-3214Email: OCSCSU@vermont.gov

Some faqsCould our VAP be rejected?Yes, it could be if someone else:

ÂWas found by a court to be the child’s parent. ÂHas a valid VAP on file. OR Â Is presumed to be a parent under the law—unless they file a Denial of Parentage (DOP) at the same time you file your VAP.

What if the birth mom was married to someone else? If she was married/civilly joined to someone else up to 300 days before your child’s birth, her spouse/former spouse is a presumed parent and must file a DOP at the same time you file your VAP.

06/20 • 7,500

Is a VAP legally binding?Yes. A signed VAP is equal to a court determination of parentage. A challenge is only allowed in limited circumstances.

You have the right to talk to a lawyer before you sign. Once you file your VAP and it’s accepted, you will be legally responsible for financially supporting the child.

Can I rescind a VAP/DOP? Yes, you can take one back by:

ÂFiling a rescission form with Vital Records — within 60 days of its effective date. OR ÂStarting a court proceeding —within 60 days of its effective date or the date of the first court hearing you’re involved with related to the child.

Learn moreFor forms, definitions and frequently-asked questions, go to: dcf.vermont.gov/ocs/services/parentage.

Free Interpretation Services If English is not your first language and you need help understanding

this information, please let us know.

Voluntary Acknowledgm

ent of Parentage (VAP)Please type or print clearly. Read all the inform

ation provided before you sign. Sign in front of a witness and m

ake sure the witness signs in both spaces on the back of this form.

Vital Records Office Use O

nly: Date received: __________________________________

Child

1. Child’s full name (first, m

iddle, last, suffix)2. D

ate of birth (mm

/dd/yyyy)

3. Child’s birthplaceCity/tow

nCounty

State

Birth Parent

4. Current legal name (first, m

iddle, last, suffix)5. Social Security num

ber

6. Date of birth (m

m/dd/yyyy)

7. Birthplace (state, territory or foreign country)

8. Mailing address (street and num

ber, city/town, state, zip code)

Parent

9. Current legal name (first, m

iddle, last, suffix)10. Social Security num

ber

11. Date of birth (m

m/dd/yyyy)

12. Birthplace (state, territory or foreign country)

13. Mailing address (street and num

ber, city/town, state, zip code)

Information About Any O

ther Parent D

oes this child have another parent/possible parent* other than the two listed on this

form?

Yes N

oIf you answ

ered yes, provide the other parent’s name below

and explain the circumstances.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________ * If som

eone else is a presumed parent under the law, they m

ust file a Denial of Parentage at

the same tim

e you file your VAP. See dcf.vermont.gov/ocs/services/parentage/definitions.

Voluntary Acknowledgm

ent of Parentage (VAP) • rev. 06/20 Form

: Page 1 of 2

Vital Records Office108 Cherry Street, PO Box 70

Burlington, VT 05402-0070(802) 863-7275 or 1-800-439-5008 (in VT only)

Through voluntary acknowledgment: If you are the genetic parents but are not married (to each other) when your child is born:1. Complete the attached VAP.2. Sign it in front of a witness who

is at least 18 years old (this can’t be either of you).

3. File it with Vital Records.

If you complete it at birth:Hospital staff (or licensed midwife if your child is born at home) will add both names to your child’s birth certificate and send your VAP to Vital Records.

If you complete it later on:Send your VAP to Vital Records. If it’s accepted, they’ll make sure both parents’ names are on the birth certificate.

What makes a VAP valid? Â It’s signed/dated by both parents who are eligible to sign. Â It’s signed/dated by a witness who is at least 18. AND Â It’s filed with Vital Records.

Establishing parentage This brochure:

ÂSummarizes the many ways to establish parentage in Vermont. ÂProvides more details about the acknowledgment option.

The method you should use will depend on the circumstances of your child’s conception  or  birth.

Through marriage/civil union: If you are married or joined through civil union — when your child is born (or up to 300 days before your child is born if the marriage or union has ended):

ÂYou don’t need to do anything to establish parentage. ÂThe law presumes both spouses are the parents (presumed parents). ÂThe hospital staff (or licensed midwife if your child is born at home) will add both parents’ names to the birth certificate and send it to Vital Records.

Through assisted reproduction: If your child will be conceived with the help of assisted reproduction —in a certified laboratory:1. Complete a Consent to Parentage

From Assisted Reproduction and file it with Vital Records. This will establish you as the intended parents.

2. You may also complete & file the attached Voluntary Acknowledgment of Parentage (VAP).

Through surrogacy: If your child will be born through a gestational carrier (surrogate):1. Hire an attorney to execute a

Gestational Carrier Agreement before the child is conceived. This will establish you as the intended parents.

2. You may also complete a VAP and file it with Vital Records.

Through court: If either of you has doubts about who the genetic parents are: 1. File an action to establish

parentage in Superior Court - Family Division.

2. The court will make a determination of parentage.

Office of Vital Records 108 Cherry Street, PO Box 70 Burlington, VT 05402-0070

1-800-439-5008

Child

’s fu

ll nam

e (fir

st, m

iddl

e, la

st, s

uffix

)

Date

of b

irth (

mm

/dd/

yyyy

)

Stat

emen

ts o

f Vol

unta

ry A

ckno

wle

dgm

ent

Both

par

ents

MUS

T in

itial

eac

h st

atem

ent b

elow

.Pa

rent

’s in

itial

sPa

rent

’s in

itial

sI U

ND

ERST

AND

TH

AT:

We

have

the

right

to ta

lk to

a la

wye

r (on

our

ow

n or

toge

ther

) bef

ore

we

sign

.

Once

we

sign

, we’

ll be

lega

lly re

spon

sibl

e fo

r fina

ncia

lly s

uppo

rtin

g th

is c

hild

.

Once

we

both

ack

now

ledg

e pa

rent

al ri

ghts

, eith

er o

ne o

f us

or th

e Of

fice

of C

hild

Su

ppor

t may

file

a p

etiti

on to

est

ablis

h a

child

sup

port

ord

er.

We

may

resc

ind

(with

draw

) thi

s VA

P —

up

to 6

0 da

ys fr

om th

e da

te it

was

file

d an

d ac

cept

ed —

by

filin

g a

resc

issi

on fo

rm w

ith th

e Of

fice

of V

ital R

ecor

ds.

Once

60

days

hav

e pa

ssed

, we’

ll ha

ve to

go

to c

ourt

to re

scin

d (w

ithdr

aw) o

r ch

alle

nge

this

VAP

. The

sam

e is

true

for a

Den

ial o

f Par

enta

ge (D

OP).

A si

gned

VAP

is e

qual

to a

cou

rt d

eter

min

atio

n of

par

enta

ge a

nd a

cha

lleng

e is

on

ly a

llow

ed in

lim

ited

circ

umst

ance

s.

Futu

re c

hang

es to

this

form

will

not

affe

ct v

alid

VAP

s.

Send

you

r com

plet

ed V

AP to

: Of

fice

of V

ital R

ecor

ds

Verm

ont D

epar

tmen

t of H

ealth

10

8 Ch

erry

Stre

et, P

O Bo

x 70

Bu

rling

ton,

VT

0540

2-00

70

Call

1-80

0-78

6-32

14 if

you

hav

e qu

estio

ns:

Offic

e of

Chi

ld S

uppo

rt s

taff

can

expl

ain:

•

Wha

t sig

ning

this

form

mea

ns

• T

he d

iffer

ent w

ays

to e

stab

lish

pare

ntag

e

Volu

ntar

y Ac

know

ledg

men

t of P

aren

tage

(VAP

) • re

v. 0

6/20

For

m: P

age

2 of

2

SIGNATURES Parents & Witness

By s

igni

ng b

elow

, we

cert

ify th

at:

• Th

e in

form

atio

n w

e pr

ovid

ed o

n th

is fo

rm is

cor

rect

to th

e be

st o

f our

kno

wle

dge.

• W

e ar

e si

gnin

g vo

lunt

arily

, with

out b

eing

sub

ject

to fo

rce,

thre

ats

or c

oerc

ion.

• W

e ha

ve re

ad &

und

erst

and

the

info

rmat

ion

prov

ided

.•

We

unde

rsta

nd th

e le

gal c

onse

quen

ces

of s

igni

ng.

Birt

h pa

rent

’s s

igna

ture

Dat

e si

gned

(mm

/dd/

yyyy

)

WIT

NES

SD

ate

sign

ed (m

m/d

d/yy

yy)

Pare

nt’s

sig

natu

reD

ate

sign

ed (m

m/d

d/yy

yy)

WIT

NES

SD

ate

sign

ed (m

m/d

d/yy

yy)

Get forms & more details: https://dcf.vermont.gov/ocs/services/parentage

PARE

NT’S

GUI

DE TO

Ac

know

ledg

ing

Pare

ntag

e in

VT

Get

hel

pVe

rmon

t’s p

aren

tage

law

can

be

stra

ight

forw

ard

or c

ompl

icat

ed,

depe

ndin

g on

the

circ

umst

ance

s.

Con

tact

OC

S if

you

need

hel

p es

tabl

ishi

ng p

aren

tage

for t

he

purp

ose

of c

hild

sup

port

. Ph

one:

1-8

00-7

86-3

214

Emai

l: OC

SCSU

@ver

mon

t.gov

Som

e fa

qsCo

uld

our V

AP b

e rej

ecte

d?Ye

s, it

cou

ld b

e if

som

eone

els

e: Â

Was

foun

d by

a c

ourt

to b

e th

e ch

ild’s

par

ent.

Â

Has

a v

alid

VA

P on

file

. OR

Â

Is p

resu

med

to b

e a

pare

nt u

nder

th

e la

w—

unle

ss th

ey fi

le a

Den

ial

of P

aren

tage

(DO

P) a

t the

sam

e tim

e yo

u fil

e yo

ur V

AP.

Wha

t if t

he b

irth m

om w

as m

arrie

d to

som

eone

else

? If

she

was

mar

ried

/civ

illy

join

ed to

so

meo

ne e

lse

up to

300

day

s be

fore

yo

ur c

hild

’s b

irth

, her

spo

use/

form

er s

pous

e is

a p

resu

med

par

ent

and

mus

t file

a D

OP

at th

e sa

me

time

you

file

your

VA

P.

06/2

0 •

7,50

0

Is a V

AP le

gally

bin

ding

?Ye

s. A

sig

ned

VAP

is e

qual

to a

co

urt d

eter

min

atio

n of

par

enta

ge.

A c

halle

nge

is o

nly

allo

wed

in

limite

d ci

rcum

stan

ces.

You

have

the

righ

t to

talk

to a

la

wye

r bef

ore

you

sign

. Onc

e yo

u fil

e yo

ur V

AP

and

it’s

acce

pted

, yo

u w

ill b

e le

gally

resp

onsi

ble

for

finan

cial

ly s

uppo

rtin

g th

e ch

ild.

Can I

resc

ind

a VAP

/DOP

? Ye

s, y

ou c

an ta

ke o

ne b

ack

by:

Â

Filin

g a

resc

issi

on fo

rm w

ith V

ital

Reco

rds

— w

ithin

60

days

of i

ts

effec

tive

date

. OR

Â

Star

ting

a co

urt p

roce

edin

g —

with

in 6

0 da

ys o

f its

effe

ctiv

e da

te o

r the

dat

e of

the

first

cou

rt

hear

ing

you’

re in

volv

ed w

ith

rela

ted

to th

e ch

ild.

Lear

n m

ore

For f

orm

s, d

efini

tions

and

fr

eque

ntly

-ask

ed q

uest

ions

, go

to:

dcf.v

erm

ont.g

ov/o

cs/s

ervic

es/p

aren

tage

.

Free

Inte

rpre

tatio

n Se

rvic

es

If En

glis

h is

not

your

firs

t lan

guag

e an

d yo

u ne

ed h

elp

unde

rsta

ndin

g th

is in

form

atio

n, p

leas

e le

t us

know

.

Voluntary Acknowledgment of Parentage (VAP)Please type or print clearly. Read all the information provided before you sign. Sign in

front of a witness and make sure the witness signs in both spaces on the back of this form.

Vital Records Office Use Only: Date received: __________________________________

Child

1. Child’s full name (first, middle, last, suffix) 2. Date of birth (mm/dd/yyyy)

3. Child’s birthplace City/town County State

Birt

h Pa

rent

4. Current legal name (first, middle, last, suffix) 5. Social Security number

6. Date of birth (mm/dd/yyyy) 7. Birthplace (state, territory or foreign country)

8. Mailing address (street and number, city/town, state, zip code)

Pare

nt

9. Current legal name (first, middle, last, suffix) 10. Social Security number

11. Date of birth (mm/dd/yyyy) 12. Birthplace (state, territory or foreign country)

13. Mailing address (street and number, city/town, state, zip code)

Information About Any Other Parent

Does this child have another parent/possible parent* other than the two listed on this form? Yes NoIf you answered yes, provide the other parent’s name below and explain the circumstances.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

* If someone else is a presumed parent under the law, they must file a Denial of Parentage at the same time you file your VAP. See dcf.vermont.gov/ocs/services/parentage/definitions.

Voluntary Acknowledgment of Parentage (VAP) • rev. 06/20 Form: Page 1 of 2

Vital Records Office108 Cherry Street, PO Box 70

Burlington, VT 05402-0070(802) 863-7275 or 1-800-439-5008 (in VT only)

Through voluntary acknowledgm

ent: If you are the genetic parents but are not m

arried (to each other) w

hen your child is born:1. C

omplete the attached VA

P.2. Sign it in front of a w

itness who

is at least 18 years old (this can’t be either of you).

3. File it with V

ital Records.

If you complete it at birth:

Hospital staff (or licensed m

idwife

if your child is born at home) w

ill add both nam

es to your child’s birth certificate and send your VA

P to Vital Records.

If you complete it later on:

Send your VAP to V

ital Records. If it’s accepted, they’ll m

ake sure both parents’ nam

es are on the birth certificate.

What m

akes a VAP valid? Â

It’s signed/dated by both parents w

ho are eligible to sign. Â

It’s signed/dated by a witness

who is at least 18. A

ND

Â

It’s filed with V

ital Records.

Establishing parentage This brochure:

Â

Summ

arizes the many w

ays to establish parentage in Verm

ont. Â

Provides more details about the

acknowledgm

ent option.

The method you should use w

ill depend on the circum

stances of your child’s conception  or  birth.

Through marriage/civil union:

If you are married or joined through

civil union — w

hen your child is born (or up to 300 days before your child is born if the m

arriage or union has ended):

Â

You don’t need to do anything to establish parentage. Â

The law presum

es both spouses are the parents (presum

ed parents). Â

The hospital staff (or licensed m

idwife if your child is born at

home) w

ill add both parents’ nam

es to the birth certificate and send it to V

ital Records.

Through assisted reproduction: If your child w

ill be conceived with

the help of assisted reproduction —in a certified laboratory:1. C

omplete a Consent to Parentage

From A

ssisted Reproduction and file it w

ith Vital Records. This will

establish you as the intended parents.2. You m

ay also complete &

file the attached Voluntary A

cknowledgm

ent of Parentage (VA

P).

Through surrogacy: If your child w

ill be born through a gestational carrier (surrogate):1. H

ire an attorney to execute a G

estational Carrier Agreem

ent before the child is conceived. This will establish you as the intended parents.

2. You may also com

plete a VAP and

file it with V

ital Records.

Through court: If either of you has doubts about w

ho the genetic parents are: 1. File an action to establish

parentage in Superior Court -

Family D

ivision. 2. The court w

ill make a

determination of parentage.

Office of Vital Records

108 Cherry Street, PO Box 70

Burlington, VT 05402-0070 1-800-439-5008

Child’s full name (first, middle, last, suffix)

Date of birth (mm/dd/yyyy)

Statements of Voluntary AcknowledgmentBoth parents MUST initial each statement below.

Parent’s initials

Parent’s initials I UNDERSTAND THAT:

We have the right to talk to a lawyer (on our own or together) before we sign.

Once we sign, we’ll be legally responsible for financially supporting this child.

Once we both acknowledge parental rights, either one of us or the Office of Child Support may file a petition to establish a child support order.

We may rescind (withdraw) this VAP — up to 60 days from the date it was filed and accepted — by filing a rescission form with the Office of Vital Records.

Once 60 days have passed, we’ll have to go to court to rescind (withdraw) or challenge this VAP. The same is true for a Denial of Parentage (DOP).

A signed VAP is equal to a court determination of parentage and a challenge is only allowed in limited circumstances.

Future changes to this form will not affect valid VAPs.

Send your completed VAP to: Office of Vital Records Vermont Department of Health 108 Cherry Street, PO Box 70 Burlington, VT 05402-0070

Call 1-800-786-3214 if you have questions: Office of Child Support staff can explain: • What signing this form means • The different ways to establish parentage

Voluntary Acknowledgment of Parentage (VAP) • rev. 06/20 Form: Page 2 of 2

SIGN

ATUR

ES

Pare

nts

& W

itnes

s

By signing below, we certify that:• The information we provided on this form is correct to the best of our knowledge.• We are signing voluntarily, without being subject to force, threats or coercion.• We have read & understand the information provided.• We understand the legal consequences of signing.

Birth parent’s signature Date signed (mm/dd/yyyy)

WITNESS Date signed (mm/dd/yyyy)

Parent’s signature Date signed (mm/dd/yyyy)

WITNESS Date signed (mm/dd/yyyy)

Get form

s & m

ore details: https://dcf.vermont.gov/ocs/services/parentage