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Montana Proof of Pregnancy Affidavit

Official state formOther requestsFree downloadLast verified November 10, 2026

Notarized statement by a witness that the mother was pregnant with the named child. It is supporting evidence for a home birth registration and is sent to Montana Vital Records with the Home Birth Worksheet.

Who can use this form

  • A person who witnessed the pregnancy
  • The signer states whether they represent the person as self, parent or other
  • The signature must be notarized

What to send with it

  • The notarized affidavit
  • Send it together with the Home Birth Worksheet

Where to send it

Mail to
See the form for where to file it.
State fee
Not provided
Typical processing
Not provided
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Montana Proof of Pregnancy Affidavit | Montana Form