Missouri DHSS - Vital Records Applications and Forms · Missouri state form
MO 580-2223 Request for Search of Putative Father Registry
Use this form to request a search of the Putative Father Registry. The requester must identify their eligibility, provide child and parent information, and sign before a notary.
- What this form is
- The Missouri Department of Health and Senior Services form requests a search of the Putative Father Registry. It collects information about the child, mother, father if known, and requester, who must identify an eligible requester category. The requester declares under penalty of perjury that they are eligible and the information is true and correct. The signature must be notarized, and the instructions require mailing the original notarized form.
- Who needs it
- A person or authorized agency, entity, or person eligible to search the Putative Father Registry may complete and submit this request.
- Why it needs a notary
- The requester must sign in the presence of a notary, and the original notarized form must be mailed. A commissioned online notary can notarize the signature online.
- How to submit it
- Print or type the form, sign it in the presence of a notary, and mail the original notarized form to DHSS - Bureau of Vital Records, 930 Wildwood Dr., Jefferson City, Missouri 65109.
Questions
Who may request a Putative Father Registry search?
The form lists the child’s mother or father, a licensed attorney, a clergyman of the child’s parent or parents, a court, DSS Children’s Division, and a licensed child-placing agency or physician.
Does MO 580-2223 need to be notarized?
Yes. The requester’s signature must be signed in the presence of a notary. The instructions also say to mail the original notarized form; a commissioned online notary can notarize the signature online.
How do I submit the completed form?
Print or type the form, sign it in the presence of a notary, and mail the original notarized form to DHSS - Bureau of Vital Records, 930 Wildwood Dr., Jefferson City, Missouri 65109.