- Your full legal name
- Social Security Number
- Birth date
- If you are Indian, the tribe(s) with which you are affiliated
- Address at which you want legal notices to be sent
- If above address is not your address, name of the person at this address to whom the notice should be sent
- Legal name of the mother of the child
- Any other names she may use
- Her Social Security Number, if known
- Her birth date, if known
- Her address, if known
- Childs name, if known
- Location (City/State) of childs birth, if known
- Location (City/State) and date of possible conception of child
See: www.dphhs.state.mt.us/services/applications_forms/putative_father_registry.htm
The form must be received no later than 72 hours after the childs birth. Actual knowledge of the pregnancy or birth is not required to file a form with the registry.
Bureau of Vital Statistics,
Department of Public Health and Human services,
111 N. Sanders, Room 205,
Helena, MT 59620
FAX (406) 444-1803 Tel: (406) 444-4228.
Return to the National Directory of Putative Father Registries.

