Mississippi Acknowledgement of Paternity (Form No. 564)
Official state formParentage and paternityForm Form No. 564Free downloadLast verified November 10, 2026
Notarized form signed by the unmarried mother and the natural father to add the father to an existing Mississippi birth certificate. It is mailed to Vital Records at the Mississippi State Department of Health.
Who can use this form
- The natural father and the mother of the child.
- Each parent signs in front of a notary public.
- Not for use if the mother is married, or was married at any time between conception and birth.
What to send with it
- The completed, notarized form with all information supplied.
- If the mother's name has changed since the birth record (by marriage, court order or other reason), documents that show the change.
- The $28.00 fee by check, bank money order or postal money order.
Where to send it
- Mail to
- Mississippi State Department of Health Vital Records Post Office Box 1700 Jackson, Mississippi 39215-1700
- State fee
- $28.00. A certified copy of the amended certificate is issued after processing. The form says it accepts checks, while the office's certified-copy instruction pages say no personal checks.
- Typical processing
- Not provided
- Form revision
- 01/01/2017
- Source
- Official government page