Paternity Agreement
ALASKA AFFIDAVIT OF PATERNITY PREPARATION PACKET
Do not sign or file this packet as an Affidavit of Paternity. Alaska uses the official Affidavit of Paternity, form VS-06-5376. Health Analytics and Vital Records supplies the form; the Alaska Court System states that it is not available online.
Keep parentage separate from parenting terms. The filed acknowledgment has statutory legal effect, but this worksheet does not create a custody schedule, set parenting time, calculate support, or provide private contract remedies.
1. Eligibility and Existing-Parentage Screen
| Question | Response |
|---|---|
| Child has been born | ☐ No ☐ Yes: [__/__/____] |
| Mother and proposed acknowledging father agree he is the child's natural father | ☐ Yes ☐ No ☐ Uncertain |
| Genetic testing is desired or biological paternity is uncertain | ☐ No ☐ Yes — stop before signing |
| Mother was married at conception, during pregnancy, or at birth | ☐ No ☐ Yes: [________________________________] |
| A spouse is listed as father on the birth certificate | ☐ No ☐ Yes: [________________________________] |
| Another person is named as a parent on the birth certificate | ☐ No ☐ Yes: [________________________________] |
| An earlier Affidavit of Paternity contains the same or different information | ☐ No ☐ Yes: [________________________________] |
| A court or agency has already determined paternity | ☐ No ☐ Yes: [________________________________] |
| An adoption, assisted-reproduction, or surrogacy issue exists | ☐ No ☐ Yes: [________________________________] |
| Existing custody, support, child-welfare, or protection case | ☐ No ☐ Yes: [________________________________] |
| Force, threat, coercion, safety, or confidential-address issue | ☐ No ☐ Yes: [________________________________] |
| Either proposed signer is under eighteen | ☐ No ☐ Yes: [________________________________] |
The Alaska Court System explains that an Affidavit of Paternity may be unavailable when an earlier affidavit contains different paternity information; a court order may then be required. If the mother is married and her husband is listed on the birth certificate, court guidance describes a possible three-person VS-06-5376 route signed by the mother, husband, and biological father. Obtain the current form and written Vital Records instructions before relying on that route.
Selected route:
☐ Mother and father use the ordinary VS-06-5376 route
☐ Mother, husband, and biological father use a Vital Records-confirmed three-person route
☐ Child Support Services administrative route
☐ Superior Court paternity route
☐ Attorney review required before a route can be selected
2. Parent and Child Information Worksheet
| Item | Information |
|---|---|
| Child's full legal name | [________________________________] |
| Child's date and place of birth | [__/__/____] — [________________________________] |
| Child's current birth-record information | [________________________________] |
| Mother's full legal name | [________________________________] |
| Mother's date of birth | [__/__/____] |
| Mother's mailing address | [________________________________] |
| Proposed father's full legal name | [________________________________] |
| Proposed father's date of birth | [__/__/____] |
| Proposed father's mailing address | [________________________________] |
| Husband or other person currently listed, if applicable | [________________________________] |
| Existing court, agency, or child-support case number | [________________________________] |
AS 18.50.165 requires the official form to collect both parents' addresses and Social Security numbers. Transfer Social Security numbers and other protected identifiers directly to the official form; do not retain them in this worksheet when unnecessary or unsafe.
3. Obtain and Review the Current Official Form
Request the current VS-06-5376 and instructions from Alaska Health Analytics and Vital Records, Special Services:
Include a mailing address in the request. The Department of Health identifies the voluntary Affidavit of Paternity as the easiest administrative way to add a parent to a birth certificate and directs applicants to Special Services for the necessary forms and instructions.
| Official-form item | Record |
|---|---|
| Form requested | [__/__/____] |
| Current form received | [__/__/____] |
| Form number and revision | [________________________________] |
| Current instructions received | [__/__/____] |
| Special Services contact or reference | [________________________________] |
Do not download a third-party substitute or recreate VS-06-5376 from this packet.
4. Rights, Voluntariness, and Testing Decision
AS 18.50.165 requires the official form to explain the legal consequences, rights, responsibilities, alternatives, any minority-related rights, the responsibility created by signing, and the limited withdrawal period. Before signing, each proposed signer should confirm:
☐ I received and read the complete current form and instructions.
☐ I understand that signing is voluntary and that a court or agency route may be available instead.
☐ I understand that the acknowledging father assumes a parental duty of support.
☐ I understand the acknowledgment's legal effect and the limited ways to withdraw or later contest it.
☐ I am signing without fraud, duress, pressure, threat, or material mistake.
☐ I am certain the selected parentage route and all facts on the form are correct.
☐ I had an opportunity to consult independent Alaska counsel.
Testing status: ☐ Completed and reviewed ☐ Not requested because paternity is certain ☐ Requested — do not sign yet
Testing provider, report date, and result: [________________________________]
AS 25.20.050(d)'s 95-percent genetic-test presumption applies to evidence used in determining parentage. It is not a private-contract threshold and does not replace the official acknowledgment, agency, or court process.
5. Execute VS-06-5376 Correctly
AS 18.50.165 requires signature lines for both parents and a signature line for either a witness or a notary public. The Alaska Court System instructs both parents to sign VS-06-5376 in front of a witness or notary. Follow every instruction on the current form.
☐ Every required person reviewed the complete form before signing.
☐ Names, dates, and birth information match the vital record and identification.
☐ Mother signed as the official form directs.
☐ Proposed father signed as the official form directs.
☐ Husband or other required signer completed the Vital Records-approved section, if applicable.
☐ A qualified witness or notary completed the required signature block.
| Execution item | Record |
|---|---|
| Mother's signature date | [__/__/____] |
| Father's signature date | [__/__/____] |
| Other required signer's date | [__/__/____] |
| Witness or notary | [________________________________] |
| Place of execution | [________________________________] |
Do not use this packet's signature page, counterparts, a private waiver, or an unsupported electronic signature as a substitute for the official form.
6. Submit the Original to Health Analytics and Vital Records
Under AS 25.20.050(b), the acknowledgment is forwarded to the Bureau of Vital Statistics, noted on the corresponding original birth certificate, and kept with that record. AS 25.20.055 requires hospitals and certain birth attendants to provide forms and assistance and, at the parents' request, mail a completed acknowledgment to the state registrar.
For a later submission, follow the current Special Services instructions. The Department of Health states that affidavits of paternity bearing original signatures cannot be faxed or emailed and that Special Services requires original or certified documents to amend a vital record.
| Filing item | Record |
|---|---|
| Person or facility responsible for submission | [________________________________] |
| Original sent or delivered | [__/__/____] |
| Delivery method and tracking | [________________________________] |
| Vital Records receipt confirmed | [__/__/____] |
| Filing or acceptance confirmed | [__/__/____] |
| Amended or substitute birth certificate requested | [________________________________] |
| Updated record received | [__/__/____] |
The cited statutes do not impose the old template's generic ten-calendar-day filing deadline. Preserve delivery and acceptance evidence and follow the current agency instructions.
7. Legal Effect; Custody and Support Remain Separate
Under AS 25.20.050(l), a completed and signed form meeting AS 18.50.165(a) is a legal finding of paternity for a child born out of wedlock. If it is not successfully challenged, subsection (m) provides that the child is legitimated and considered the acknowledging parent's heir without further tribunal action to ratify the acknowledgment.
The acknowledgment does not itself supply a detailed parenting plan or determine a support amount. Use the appropriate Superior Court or Child Support Services process for custody, parenting time, support, medical coverage, or enforcement.
| Separate issue | Proposal or existing order |
|---|---|
| Legal and physical custody | [________________________________] |
| Parenting-time schedule | [________________________________] |
| Child-support calculation and payment route | [________________________________] |
| Health insurance and uncovered expenses | [________________________________] |
| Safety conditions or supervised contact | [________________________________] |
| Court, location, and case number | [________________________________] |
Do not attach private default clauses, cure periods, fee shifting, indemnity, damages caps, force majeure, arbitration, jury waivers, automatic custody changes, or support terms to the Affidavit as though they were part of the statutory form or a court order.
8. Withdrawal During the Statutory Window
For an acknowledgment signed on or after July 1, 1997, AS 25.20.050(l) permits withdrawal only by the earlier of:
- sixty days after the date that the withdrawing person signed it; or
- initiation of a judicial or administrative procedure to establish periodic support or health-care coverage for, or determine paternity of, the child, when that person is a party.
The Alaska Court System states that a revocation form is available from the Health Analytics and Vital Records paternity clerk. Obtain the current official form and filing instructions immediately; do not use a private cancellation letter.
| Withdrawal-calendar item | Date |
|---|---|
| Mother's signature date and sixtieth day | [________________________________] |
| Father's signature date and sixtieth day | [________________________________] |
| Earliest related support or paternity procedure initiated | [________________________________] |
| Counsel-confirmed controlling deadline | [________________________________] |
| Official withdrawal/revocation form obtained | [__/__/____] |
| Form filed and receipt confirmed | [________________________________] |
9. Contest After the Withdrawal Period
After the statutory withdrawal period, AS 25.20.050(l) allows an acknowledgment to be contested only in Superior Court and only on the basis of fraud, duress, or material mistake. The contesting parent bears the burden of proof by a preponderance of the evidence. Unless good cause is shown, the court may not stay child support or other legal responsibilities while the contest is pending.
This packet is not a complaint, motion, or request to disestablish paternity. Obtain immediate Alaska legal review concerning the proper parties, court, pleading, service, evidence, interim duties, and requested birth-record relief.
10. Preparation Acknowledgment
The signatures below confirm only that the participants reviewed this preparation packet. They do not acknowledge, withdraw, revoke, establish, or disestablish paternity and do not create custody, parenting-time, or support orders.
| Signer | Signature | Date |
|---|---|---|
| Mother | ______________________________ | [__/__/____] |
| Proposed father | ______________________________ | [__/__/____] |
| Husband or other participant, if applicable | ______________________________ | [__/__/____] |
| Reviewing Alaska attorney, if any | ______________________________ | [__/__/____] |
Sources and References
About this template
- Last updated
- August 8, 2026
- Citations checked
- August 8, 2026
- Jurisdiction
- Alaska
- Category
- Family Law
Legal authority
- AS 18.50.165 (acknowledgment form, required contents, execution, withdrawal notice, and filing)
- AS 25.20.050 (legal effect, withdrawal, later contest, and birth-record treatment)
- AS 25.20.055 (hospital, midwife, and filing-assistance program)
- Alaska Affidavit of Paternity, VS-06-5376
Family law covers the paperwork that shapes divorce, custody, child support, adoption, guardianship, and other family matters. These filings are emotional and high-stakes, and they also have to meet strict procedural rules for service, financial disclosure, and parenting plans. Clean, accurate paperwork keeps the focus on getting a workable outcome for the family instead of getting derailed by technical problems that delay hearings or force amended filings.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on August 8, 2026.
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