Free - Massachusetts

Division

Commonwealth of Massachusetts The Trial Court Probate and Family Court Department

Docket No.

Plaintiff/Petitioner

V.

Defendant/Respondent

AFFIDAVIT IN SUPPORT OF MOTION FOR CITY/TOWN CLERK TO RELEASE A COPY OF THE CHILD'S BIRTH CERTIFICATE
states:

In support of my motion for the city/town clerk to release a copy of a child's birth certificate, I am unable to obtain the childs birth certificate for the following reason(s). I am the father of the minor child,
(Name of Minor Child)

in the above entitled case. My name is not listed on the birth certificate and the City /Town Clerk will not release it to me.

Signed under the pains and penalties of perjury.

Date

(Signature of attorney or plaintiff, if pro se)

Affidavit in Support Release Birth Certificate

C.G.F.