Missouri Putative Father Registry Revocation of Notice of Intent to Claim Paternity (MO 580-3371 (VS-422))
Official state formParentage and paternityForm MO 580-3371 (VS-422)Free downloadLast verified November 10, 2026
Revokes a Notice of Intent to Claim Paternity that was filed earlier with the Missouri Putative Father Registry. It is mailed to the Bureau of Vital Records.
Who can use this form
- A father who has filed a Notice of Intent to Claim Paternity
- The form says he may revoke the notice at any time
What to send with it
- The completed form, typed or printed in black ink
- His signature made in the presence of a notary
Where to send it
- Mail to
- DHSS - Bureau of Vital Records 930 Wildwood Dr. Jefferson City, MO 65109
- State fee
- Not provided
- Typical processing
- Not provided
- Form revision
- 6-2021
- Source
- Official government page