NOTICE OF INTENT TO CLAIM PATERNITY

(40-6-126, MCA)

STATE OF MONTANA
COUNTY OF _________________________

I, _______________________________, born on ___________________________, hereby serve
          Father’s Name                                                                             Date                                                          
notice that I intend to claim paternity of the child or children currently expected to be born to 

 ______________________________________, who resides at __________________________, 
           Mother’s Maiden Name                                                                                     Street address 

________________________, Montana.  Expected date of delivery:_______________________.
                  City

Signature:____________________________________

Address:___________________________________
     	Street
           							         ___________________________________________________
   City                         State                                             Zip

Subscribed and sworn to before me this _____ day of ______________________, 20______.

____________________________________________________
(NOTARY SEAL)			Notary Public for the State of Montana
_____________________________________________
Printed Signature
Residing at:  ________________________________
My Commission expires:  _______________________

If this is being filed in response to Notice Of Intent To Release by the mother, please state:

Name of Court:________________________________

Court File Number:_____________________________