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Adoption- Affidavit of Nonpaternity

If a stepfather wishes to adopt his stepson/stepdaughter, this form has to be used in the legal process of the adoption. This affidavit can substitute for a written consent.

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Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(3), Affidavit of 	Nonpaternity (	03/15	) 	
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW 	
FORM 12.981(a)(3),	 	
AFFIDAVIT OF NONPATERNITY (03/15	) 	
 
 	 	
 	When should this form be used?	 	
 
This form should be used when a stepfather is adopting his wife	’s minor child 	and	 the mother and father of 	
the minor child(ren) were never married 	and	 paternity has not been established by a valid acknowl	edgment 	
or court order. 	This Affidavit of Nonpaternity may be u	sed instead of a consent form. 	This Affidavit may be 	
executed  before  the  birth  of  the  minor  child	.  The  person  signing  the  affidavit  waives  notice  to  all  court 	
proceedings after the date it is	 signed. 	After signing this affidavit, it may only be withdrawn if the court finds 	
the affidavit was obtained by fraud or duress.	 	
 
 This form should be 	typed or p	rinted in black ink. 	This form must be signed before a 	notary public	 or 	deputy 	
clerk	 and two witnesses o	ther than the notary or clerk. 	You should then 	file	 the original of this form with the 	
Joint 	Petition for Stepparent Adoption,	 Florida Supreme Court App	roved Family Law Form 12.981(b)(1).	 	
 
 
 	 	 	IMPORTANT INFORMATION REGARDING E	-FILING	 	
 
The Florida Rules of Judicial Administration now require that petitions, pleadings, and documents be filed 
electronically  except  in  certain  circumstances. 	Self	-represented  l	itigants  may  file	 petition	s or  other 	
pleadings electronically; however, they are not required to do so. 	If y	ou choose to file your	 pleading	s or 	
other 	document	s electronically, you must 	do so in accordance with Florida Rule of Judicial Administration 	
2.525,	 and you must follow the procedures of the judicial circuit in which you file. 	The rules and procedures 	
should be carefully read and followed.	 	
 
 	 	 	 	 	
 	 	 	 	 	Special Notes	 	
 
Remember	--a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps 	you fill out these 	
forms,  that  person  must  give  you  a  copy  of  a 	Disclosure  from  Nonlawyer	, Florida  Family  Law  Rules  of 	
Procedure Form 12.900 (a	), before he or she helps you. 	A nonlawyer helping you fill out these forms also 	
must	 put his or her name, addres	s, and telephone number on the bottom of the last page of every form he 	
or she helps you complete.

Florida Supreme Court Approved Family Law Form 12.981(a)(3), Affidavit of Nonpaternity 	(03/15	) 	
IN THE CIRCUIT COURT OF THE 	        	 JUDICIAL CIRCUIT,	 	
IN AND 	FOR 	                    	__	 COUNTY, FLORIDA	 	
 	
Case No.: 	 	 	
Division: 	 	 	
 
IN THE MATTER OF THE ADOPT	ION OF 	 	
 	
 	
_________________________________	__________	, 	
{use name to 	of 	the minor child(ren)}	Adoptee	(s)	 	
 	 	
 
 	AFFIDAVIT OF NONPATERNITY	 	
 
I, {full legal name}	  	 	 	 	 	 	, have  personal  knowledge  of  the  facts 	
stated in this affidavit and certify that the following 	statements are true:	 	
 
1. 	I have been told that 	{name	} 	 	 	 	 	 has a child.  I do not wish to 	
and shall not establish or claim paternit	y for this child, whose name is ___________________	 	
and 	whose date of birth is_____________________________	. 	
2. 	The child reference	d in this affidavit was not conceived or born while the birth mother was 	
marrie	d to me. 	I AM NOT MARRIED TO THE BIRTH MOTHER, nor do I intend to marry the birth 	
mother.	 	
3. 	The child has not been established to be my child in any court proceeding and I have no	t adopted 	
this child.	 	
4. 	I  have  no  interest  in  assuming  the  responsibilities  of  parenthood  for  this  child.    I  have  not 
acknowledged  and  will  not  acknowledge  in  writing  that  I  am  the  father  of  this  child  or  will  not 
institute court proceedings to establish the	 child as mine.	 	
5. 	I  do  not  object  to  any  decision  or  arrangements  the  birth  mother  makes  regarding  this  child, 
including adoption.	 	
6. 	I  understand  my  right  to  choose  a  person  who  does  not  have  an  employment,  professional,  or 
personal relationship with the	 adoption entity or the prospective adoptive parents to be present 	
when this affidavit is executed and to sign it as a witness.  The witness I selected is 	{full legal name}	
 	 	 	 	 	 	. 	
7. 	I am executing this affidavit freely and voluntarily and I understand tha	t it can only be withdrawn if 	
the court finds it was executed by fraud or duress.	 	
  
 
I  WAIVE  NOTICE  OF  ANY  AND  ALL  PROCEEDINGS  TO  TERMINATE  PARENTAL  RIGHTS  OR  FINALIZE  AN 
ADOPTION UNDER CHAPTER 63, FLORIDA STATUTES.

Florida Supreme Court Approved Family Law Form 12.981(a)(3), Affidavit of Nonpaternity 	(03/15	) 	
I understand that I am swearing or	 affirming under oath to the truthfulness of the claims made in this 	
affidavit 	and  that  the  punishment  for  knowingly  making  a  false  statement  includes  fines  and/or 	
imprisonment.	 	
 	 	
Signature 	 	
Printed Name: __________________________________	 	
Address: _______	________________________________	 	
City, State, Zip: _________________________________	 	
Designated E	-mail Address(es):_____________________	 	
 	 	 	 	 	 	_________________________________________	 	
 	 	 	 	
 
 
 	 	
Signature of Witness	 	
Printed Name: 	 	 	
Business Address: 	 	 	
Home 	Address: 	 	 	
Driver	’s License or 	 	
State ID Card No.:	 	 	
 	
 
 
 	 	
Signature of Witness	 	
Printed Name: 	 	 	
Business Address: 	 	 	
Home Address: 	 	 	
Driver	’s License or	 	
State ID Card No.:	 	 	
 
 
STATE OF FLORIDA	 	
COUNTY OF 	                                        	 	
 
Sworn to or 	affirmed and signed before me on 	{date	}                               	 . 	
 
 	
 	 	
NOTARY PUBLIC or DEPUTY CLERK 	 	
 	
 	 	
[Print,  type,  or  stamp  commissioned  name  of  notary  or 
deputy clerk.]	 	
_____	Personally known	 	
_____	Produced identification	 	
           	Type of identi	fication produced 	                                              	 	
 	
 	
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:	 	
 [fill in 	all	 blanks]	 This form was prepared for the: 	{choose only 	one} 	(  ) parent or (   ) stepparent	 	
This form was completed with the assistance of:	 	
{name of 	individual	}__________________________________	_______________________________	, 	
{name of business}	 ___________________________________________________________________,	 	
{address} ________________________	___________________________________________________	,  	
{city}	  	________________,	 {state	} __	__	, {zip code}_________	{tele	phone	 number	} ________________.	 	
.
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