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Get Ms Form 564 2017-2025

) CHILD S NAME 1. CHILD- NAME FATHER S INFORMATION TO APPEAR ON REVISED CERTIFICATE AND RESIDENCE INFORMATION 4. NAME (First) (First) (Middle) (Last) (Middle) 2. DATE OF BIRTH (Month, Day, Year) 3. COUNTY OF BIRTH (Last) 5.FATHER S RACE (Check one or more races to indicate what the father considers himself to be) White Black or African American Asian Indian Chinese Filipino Japanese Korean Vietnamese Native Hawaiian Guamanian or Chamorro Samo.

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