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Econo
DNA Testing - Mail In Case Establishment Form
Please print this form using the print button on your web browser. Fill out form completely, especially including the telephone number(s). |
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Mother's Name: |
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DOB:
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Address:
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City,
State, Zip Code:
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Phone
(home, work):
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Child's
Name:
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DOB:
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Address:
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City,
State, Zip Code:
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Phone
(home, work):
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Alleged
Father's Name:
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DOB:
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Address:
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City,
State, Zip Code:
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Phone
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*Additional Tested Person: |
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Relationship:
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DOB:
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Address:
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City,
State, Zip Code:
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Phone
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| *note - extra fee will apply for additional tested person. Call* for details | |||||||||||||||||
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Payment |
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Full payment or a deposit of $100 is required to initiate the paternity testing / DNA testing process. We accept MasterCard, Visa, Discover, American Express and payment by Money Order. Please do not mail cash. The $100 deposit is non- refundable after the process has been initiated. The paternity testing collection kit will be mailed to you at no charge at your request. For "fast" and "ultra fast" testing, full payment must be received prior to or along with collection specimens. Once we have received this form, our client services department will mail your paternity test / DNA test collection kit to you. |
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Exact Name on Card: _____________________________ Cardholder's Signature: _____________________________
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Mail to: Econo DNA Testing, 10675 Treena
St. Suite 103, CA 92131
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© Copyright 2004 - 2006 Econo DNA Testing. All rights reserved.