Missouri DHSS - Vital Records Applications and Forms · Missouri state form

Rescission of Affidavit Acknowledging Paternity MO 580-2216

Use MO 580-2216 to rescind the legal finding of paternity created by a previously completed Affidavit Acknowledging Paternity. The rescinding party signs before a notary or two witnesses.

What this form is

This form lets the mother or father rescind the legal finding of paternity created by a previously completed Affidavit Acknowledging Paternity. Complete it in black ink, then sign before a notary public or two witnesses. File it with the Missouri Department of Health and Senior Services, Bureau of Vital Records, within the earlier of 60 days from the last signature on the original affidavit or the date of a child support proceeding. Rescission alone does not remove the acknowledging father's name from the birth certificate.

Who needs it

A mother or father who wants to rescind the legal finding of paternity created by a previously completed Affidavit Acknowledging Paternity may complete this form.

Why it needs a notary

The rescinding party must sign before a notary or two witnesses. If choosing notarization, the signature can be notarized online with a commissioned online notary.

How to submit it

Complete the form in black ink and file it with the Missouri Department of Health and Senior Services, Bureau of Vital Records, at 930 Wildwood Dr., Jefferson City, MO 65109, within the stated time limit.