Home Paternity Kit Order Form Step 1 of 4 25% Participants*234Shipping Address*OneTwoShipping*2-3 Day - FreeExpress - $20Shipping*2-3 Day - FreeExpress - $40Total $0.00 Participant #1Name* First Last Date of Birth* Relationship*Father | Alleged FatherMotherSonDaughterAuntUncleGrand-FatherGrand-MotherNieceNephewGrandsonGranddaughter1/2 Sister (testing to see if you share the same mother or father)Full Sister (testing to see if you share the same mother and same father)1/2 Brother (testing to see if you share the same mother or father)Full Brother (testing to see if you share the same mother and same father)Participant #2Name* First Last Date of Birth* Relationship*Father - Alleged FatherMotherSonDaughterAuntUncleGrand-FatherGrand-MotherNieceNephewGrandsonGranddaughter1/2 Sister (testing to see if you share the same mother or father)Full Sister (testing to see if you share the same mother and same father)1/2 Brother (testing to see if you share the same mother or father)Full Brother (testing to see if you share the same mother and same father)Participant #3Name* First Last Date of Birth* Relationship*Father - Alleged FatherMotherSonDaughterAuntUncleGrand-FatherGrand-MotherNieceNephewGrandsonGranddaughter1/2 Sister (testing to see if you share the same mother or father)Full Sister (testing to see if you share the same mother and same father)1/2 Brother (testing to see if you share the same mother or father)Full Brother (testing to see if you share the same mother and same father)Participant #4Name* First Last Date of Birth* Relationship*Father - Alleged FatherMotherSonDaughterAuntUncleGrand-FatherGrand-MotherNieceNephewGrandsonGranddaughter1/2 Sister (testing to see if you share the same mother or father)Full Sister (testing to see if you share the same mother and same father)1/2 Brother (testing to see if you share the same mother or father)Full Brother (testing to see if you share the same mother and same father)Shipping InformationShipping Name* First Last Shipping Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Shipping Name #2* First Last Shipping Address #2* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Security Word/Number*This security phrase will be used to verify your identity later when receiving results. Any word or phrase less than 8 characters is allowed.Extra InformationAdd any extra relevant information related to your home paternity test.Contact Phone*Contact Email* Enter Email Confirm Email Total $0.00 Coupon Billing InformationBilling Name First Last Billing Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please note that the card billing address must match the address on record with the credit card company where your statements are sent.Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Phone*Email*