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Chapter 246-491 WAC

Last Update: 6/5/20

VITAL STATISTICS—CERTIFICATES

WAC Sections

HTMLPDF246-491-001Purpose.Effective until January 1, 2021
HTMLPDF246-491-010Definitions.
HTMLPDF246-491-029Information collected on the confidential section of live birth and fetal death certificates; modifications to the United States standard certificates and report forms.
HTMLPDF246-491-039Obtaining confidential information on birth and fetal death records.
HTMLPDF246-491-149Information collected on the legal or public section of vital records.
HTMLPDF246-491-159Items on birth and death certifications and informational copies.
HTMLPDF246-491-300Requirements for ordering certifications of birth, death, and fetal death.
HTMLPDF246-491-310Information required to order certifications of birth, death, and fetal death.
HTMLPDF246-491-320Identity documentation required to obtain certifications of birth, death, and fetal death.
HTMLPDF246-491-330Evidence of eligibility.
HTMLPDF246-491-340Requirements for ordering certifications of marriage, dissolution of marriage, and dissolution of domestic partnership.
HTMLPDF246-491-350Requirements for certifications of vital records at no charge.
HTMLPDF246-491-360Requirements for ordering informational copies of birth and death records.
HTMLPDF246-491-370Notification of no record.
HTMLPDF246-491-990Vital records fees.
DISPOSITION OF SECTIONS FORMERLY CODIFIED IN THIS TITLE
246-491-001Purpose. [Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. WSR 02-20-092, § 246-491-001, filed 10/1/02, effective 11/1/02.] Repealed by WSR 20-13-017, filed 6/5/20, effective 1/1/21. Statutory Authority: 2019 c 148.


(Effective until January 1, 2021)

PDF246-491-001

Purpose.

RCW 70.58.055 requires certificates for vital records to include, at a minimum, items recommended by the federal agency responsible for national vital statistics. RCW 70.58.055 allows the state board of health to require additional information for the confidential section of the birth certificate, and eliminate items from the federal forms that it identifies as not necessary for statistical study.
RCW 43.70.150 requires the secretary of the department of health to operate and maintain a state system for registering births, deaths, fetal deaths, marriages, divorce decrees, annulments and separations. RCW 43.70.160 requires the state registrar to prepare, print and supply the forms for registering, recording, and preserving vital statistics. These rules identify the forms used and information collected by the state on live birth, death, fetal death, marriage, divorce, dissolution of marriage and annulment.
[Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. WSR 02-20-092, § 246-491-001, filed 10/1/02, effective 11/1/02.]



(Effective until January 1, 2021)

PDF246-491-010

Definitions.

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise:
(1) "Board" means the state board of health.
(2) "Department" means the department of health.
[Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. WSR 02-20-092, § 246-491-010, filed 10/1/02, effective 11/1/02.]
(Effective January 1, 2021)

PDF246-491-010

Definitions.

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise:
(1) "Authorized representative" means a person permitted to receive a certification who is:
(a) Identified in a notarized statement signed by a qualified applicant; or
(b) An agency identified in a power of attorney as defined in chapter 11.125 RCW.
(2) "Board" means the state board of health.
(3) "Certification" means the document, in either paper or electronic format, containing all or part of the information contained in the original vital records from which the document is derived, and is issued from the central vital records system. A certification includes an attestation by the state or local registrar to the accuracy of information, and has the full force and effect of the original vital record.
(4) "Department" means the department of health.
(5) "Informational copy" means a birth or death record issued from the central vital records system, containing all or part of the information contained in the original vital record from which the document is derived, and indicating it cannot be used for legal purposes on its face.
(6) "Legal guardian" means a person who serves as a guardian for the purpose of either legal or custodial matters, or both, relating to the person for whom the guardian is appointed. The term legal guardian includes, but is not limited to, guardians appointed pursuant to chapters 11.88 and 13.36 RCW.
(7) "Legal representative" means a licensed attorney representing either the subject of the record or qualified applicant.
(8) "Qualified applicant" means a person who is eligible to receive a certification of a vital record based on the standards established by chapter 70.58A RCW and this chapter.
(9) "Report" means an electronic or paper document containing information related to a vital life event for the purpose of registering the vital life event.
(10) "Vital life event" means a birth, death, fetal death, marriage, dissolution of marriage, dissolution of domestic partnership, declaration of invalidity of marriage, declaration of invalidity of domestic partnership, and legal separation.
(11) "Vital record" or "record" means a report of a vital life event that has been registered and supporting documentation.
(12) "Vital records system" means the statewide system created, operated, and maintained by the department.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-010, filed 6/5/20, effective 1/1/21. Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. WSR 02-20-092, § 246-491-010, filed 10/1/02, effective 11/1/02.]



PDF246-491-029

Information collected on the confidential section of live birth and fetal death certificates; modifications to the United States standard certificates and report forms.

(1) Effective January 1, 2003, the department shall use the 2003 revisions of the United States standard forms of live birth and fetal death as the basis for the state certificates of live birth and fetal death. These forms are developed by the United States Department of Health and Human Services, National Center for Health Statistics.
(2) Copies of these forms may be obtained by contacting the department's center for vital statistics.
(3) Tables 1 and 2 list the statistical information contained in the confidential sections of the birth and fetal death certificates that the board requires the department to collect, and the differences between the state and U.S. standard.
u.s. standard certificate of live birth
TABLE 1:
Confidential Birth Certificate Items
Item Number
Item Name
Difference from U.S. Standard, if any
15
Is mother married to the father?
 
 
If no, was mother married to anyone during the pregnancy?
Added
 
Has the paternity affidavit been signed?
 
20
Mother's education
Add "Specify": next to box for "8th Grade or less"
21
Mother of Hispanic origin?
 
22
Mother's race
 
23
Mother's occupation
Added
24
Mother's kind of business/industry
Added
29
Father's education
Add "Specify": next to box for "8th Grade or less"
30
Father of Hispanic origin?
 
31
Father's race
 
32
Father's occupation
Added
33
Father's kind of business/industry
Added
34
Mother's medical record number
 
35
Mother's prepregnancy weight
 
36
Mother's weight at delivery
 
37
Mother's height
 
38
Did mother get WIC food for herself during pregnancy?
 
39
Cigarette smoking before and during pregnancy
 
40a
Number of previous live births
 
40b
Date of last live birth
 
41a
Number of other pregnancy outcomes
 
41b
Date of last other pregnancy outcome
 
42a
Date of first prenatal care visit
 
42b
Date of last prenatal care visit
 
43
Total number of prenatal visits for this pregnancy
 
44
Date last normal menses began
 
45
Was mother transferred to higher-level care for maternal medical or fetal indications for delivery?
 
46
Principal source of payment for this delivery
Add "Indian Health" and "CHAMPUS"
47
Newborn medical record number
 
48
Birth weight
 
49
Infant head circumference
Added
50
Obstetric estimate of gestation
 
51
Apgar score at 5 min; if score is less than 6, score at 10 minutes
 
52
Plurality
 
53
If not single birth - born 1st, 2nd, 3rd etc.
 
54
Was infant transferred within 24 hours of delivery?
 
55
Is infant living at time of the report?
 
56
Is infant being breastfed?
 
57
Risk factors in this pregnancy
Add "Group B streptococcus culture positive"
58
Method of delivery
 
59
Infections present and/or treated during this pregnancy
Add "HIV infection" and "Other: Specify"
60
Obstetric procedures
 
61
Abnormal conditions of the newborn
 
62
Characteristics of labor and delivery
 
63
Congenital anomalies of the newborn
 
64
Maternal morbidity
 
65
Onset of labor
 
u.s. standard report of fetal death
TABLE 2:
Confidential Fetal Death Certificate Items
Item Number
Item Name
Difference from U.S. Standard, if any
38
Weight of fetus
 
39
Obstetric estimate of gestation
 
40
Plurality
 
41
If not single birth - Born 1st, 2nd, 3rd etc.
 
42
Mother's education
Add "Specify": next to box for "8th Grade or less"
43
Mother of Hispanic origin?
 
44
Mother's race
 
45
Mother's occupation
Added
46
Mother's kind of business/industry
Added
47
Mother married?
 
48
Mother's height
 
49
Did mother get WIC food for herself during pregnancy?
 
50
Mother's prepregnancy weight
 
51
Mother's weight at delivery
 
52
Date last normal menses began
 
53
Date of first prenatal care visit
 
54
Date of last prenatal care visit
 
55
Total number of prenatal visits for this pregnancy
 
56a
Number of previous live births
 
56b
Date of last live birth
 
57a
Number of other pregnancy outcomes
 
57b
Date of last other pregnancy outcome
 
58
Cigarette smoking before and during pregnancy
 
59
Was mother transferred to higher-level care for maternal medical or fetal indications for delivery?
 
60
Father's education
Added
61
Father of Hispanic origin?
Added
62
Father's race
Added
63
Father's occupation
Added
64
Father's kind of business/industry
Added
65
Risk factors in this pregnancy
 
66
Method of delivery
 
67
Congenital anomalies of the fetus
 
68
Maternal morbidity
 
69
Infections present and/or treated during this pregnancy
Add "HIV infection" and "Other:
Specify"
[Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. WSR 02-20-092, § 246-491-029, filed 10/1/02, effective 11/1/02. Statutory Authority: Chapter 70.58 RCW. WSR 91-20-073 (Order 196B), § 246-491-029, filed 9/26/91, effective 10/27/91. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-491-029, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 70.58.200. WSR 88-19-092 (Order 310), § 248-124-010, filed 9/20/88. Statutory Authority: RCW 43.20.050 and 70.58.200. WSR 84-02-004 (Order 270), § 248-124-010, filed 12/23/83; Order, § 248-124-010, filed 9/1/67.]



(Effective until January 1, 2021)

PDF246-491-039

Confidential information on state of Washington live birth and fetal death certificates under chapter 70.58 RCW.

(1) The confidential sections of the certificate of live birth and the certificate of fetal death are not subject to public inspection and may not be included on certified copies of the record except upon order of a court, or as specified in subsection (2) of this section.
(2) An individual who is the subject of the birth certificate may request the confidential information from that individual's birth certificate.
(a) All requests are to be made to the department on a form provided by the department.
(b) In order to obtain the confidential information:
(i) The individual and the subject of the birth certificate must be the same person.
(ii) The individual must have proof of identity as specified in (c) of this subsection.
(c) Proof of identity includes:
(i) A current document issued by a federal or state government with the individual's name, date of birth, photograph, signature, and physical description.
(ii) A legal record documenting any name change, if needed, to verify that the individual and the subject of the birth certificate are the same person.
(iii) If not applying in person, a notarized signature of the individual making the request must be included with the proof of identity.
(d) The department shall, upon receipt of a request in compliance with (a) through (c) of this subsection, provide to the individual the following items, as available from their birth certificate:
(i) Newborn medical record number;
(ii) Birth weight;
(iii) Infant head circumference;
(iv) Obstetric estimate of gestation;
(v) Apgar scores;
(vi) Infant transferred within twenty-four hours of delivery;
(vii) Abnormal conditions of the newborn; and
(viii) Congenital anomalies of the newborn.
[Statutory Authority: RCW 70.58.055. WSR 10-10-041, § 246-491-039, filed 4/27/10, effective 5/28/10. Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. WSR 02-20-092, § 246-491-039, filed 10/1/02, effective 11/1/02. Statutory Authority: Chapter 70.58 RCW. WSR 91-20-073 (Order 196B), § 246-491-039, filed 9/26/91, effective 10/27/91. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-491-039, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 70.58.200. WSR 88-19-092 (Order 310), § 248-124-015, filed 9/20/88.]
(Effective January 1, 2021)

PDF246-491-039

Obtaining confidential information on birth and fetal death records.

(1) The confidential sections of birth and fetal death records shall not be released except upon order of a court with jurisdiction over the department or as specified in subsection (2) of this section.
(2) The individual who is the subject of a birth record may request the confidential information as described in (c) of this subsection related to their own birth record if they comply with the following requirements:
(a) An individual must submit a request to the department on the required form and provide proper identity documentation as described in (b) of this subsection.
(b) Any person requesting confidential information contained in their own birth record must provide the department with valid proof of identity. For the purpose of this section, proof of identity means:
(i) A current and valid government issued identification that contains a photograph.
(ii) A legal record documenting any name change, if needed, to verify that the individual and the subject of the birth record are the same person.
(iii) If the individual making the request is not applying in person, a notarized signature of the individual making the request must be included with the proof of identity.
(c) The department shall, upon receipt of a request that complies with (a) and (b) of this subsection to the satisfaction of the state registrar, provide the individual with only the following items, if available, from their birth record:
(i) Newborn medical record number;
(ii) Birth weight;
(iii) Infant head circumference;
(iv) Obstetric estimate of gestation;
(v) Apgar scores;
(vi) Infant transferred within twenty-four hours of delivery;
(vii) Abnormal conditions of the newborn; and
(viii) Congenital anomalies of the newborn.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-039, filed 6/5/20, effective 1/1/21. Statutory Authority: RCW 70.58.055. WSR 10-10-041, § 246-491-039, filed 4/27/10, effective 5/28/10. Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. WSR 02-20-092, § 246-491-039, filed 10/1/02, effective 11/1/02. Statutory Authority: Chapter 70.58 RCW. WSR 91-20-073 (Order 196B), § 246-491-039, filed 9/26/91, effective 10/27/91. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-491-039, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 70.58.200. WSR 88-19-092 (Order 310), § 248-124-015, filed 9/20/88.]



(Effective until January 1, 2021)

PDF246-491-149

Information collected on the legal or public section of certificates; modifications to the United States standard certificates and report forms.

(1) Effective January 1, 2003, the department shall use the 2003 revisions of the United States standard forms for live birth and fetal death.
(2) Effective January 1, 2004, the department shall use the 2003 standard form for death.
(3) Effective January 1, 1992, the department shall use the 1988 revisions of the United States standard forms for marriage and certificate of divorce, dissolution of marriage or annulment.
(4) These forms are developed by the United States Department of Health and Human Services, National Center for Health Statistics. Copies of these forms may be obtained by contacting the department's center for vital statistics.
(5) With the exception of the confidential section, the department may modify any part of these forms.
(a) Table 3 identifies the modifications to the United States standard form for live birth.
(b) Table 4 identifies the modifications to the United States standard form for fetal death.
(c) Table 5 identifies the modifications to the United States standard form for death.
(d) Table 6 identifies modifications to the United States standard form for marriage.
(e) Table 7 identifies modifications to the United States standard form for certificate of divorce, dissolution of marriage, or annulment.
(6) Table 8 lists items to be collected on the certificate of dissolution of Washington state domestic partnership. This is a Washington state form not addressed in the United States standard forms.
(7) Modification to the United States standard form for marriage for parties who previously had a state-registered domestic partnership. Parties who previously had a state-registered domestic partnership and become married in Washington may obtain an amended marriage certificate from the state registrar that includes the legal date of marriage. Marriage certificates issued to parties who have a state-registered domestic partnership and who are deemed married under RCW 26.60.100 shall include the legal date of marriage of the parties. The legal date of marriage is defined in RCW 26.60.100(4) as the date of the original state-registered domestic partnership.
U.S. STANDARD CERTIFICATE OF LIVE BIRTH
Table 3:
Legal or Public Birth Certificate Items
Item Number
Item Name
Difference from U.S. Standard, if any
1
Child's name
 
2
Child's date of birth
 
3
Time of birth
 
4
Type of birthplace
Add "En route," Add "Planned birthplace if different"
5
Child's sex
 
6
Name of facility
 
7
City, town or location of birth
 
8
County of birth
 
9
Mother's name before first marriage
 
10
Mother's date of birth
 
11
Mother's birthplace
 
12
Mother's Social Security number
 
13
Mother's current legal last name
 
14
Social Security number requested for child?
 
16a
Mother's residence - Number, street, and Apt. No.
 
16b
Mother's residence - City or town
 
16c
Mother's residence - County
 
16d
Tribal reservation name (if applicable)
Added
16e
Mother's residence - State or foreign country
 
16f
Mother's residence - Zip code + 4
 
16g
Mother's residence - Inside city limits?
 
17
Telephone number
Added
18
How long at current residence?
Added
19
Mother's mailing address, if different
 
25
Father's current legal name
 
26
Father's date of birth
 
27
Father's birthplace
 
28
Father's Social Security number
 
66
Certifier name and title
Delete check boxes
67
Date certified
 
68
Attendant name and title
Delete check boxes
69
NPI of person delivering the baby
 
Date filed by registrar
Deleted
U.S. STANDARD REPORT OF FETAL DEATH
Table 4:
Legal or Public Fetal Death Certificate Items
Item Number
Item Name
Difference from U.S. Standard, if any
1
Name of fetus
 
2
Sex
 
3
Date of delivery
 
4
Time of delivery
 
5
Type of birthplace
Add "En route," Add "Planned birthplace if different"
6
Name of facility
 
7
Facility ID (NPI)
 
8
City, town or location of birth
 
9
Zip code of delivery
 
10
County of birth
 
11
Mother's name before first marriage
 
12
Mother's date of birth
 
13
Mother's current legal last name
 
14
Mother's birthplace
 
15a
Mother's residence - Number, street, and Apt. No.
 
15b
Mother's residence - City or town
 
15c
Mother's residence - County
 
15d
Tribal reservation name (if applicable)
Added
15e
Mother's residence - State or foreign country
 
15f
Mother's residence - Zip code + 4
 
15g
Mother's residence - Inside city limits?
 
16
How long at current residence?
Added
17
Father's current legal name
 
18
Father's date of birth
 
19
Father's birthplace
 
20
Name and title of person completing the report
 
21
Date report completed
 
22
Attendant name and title
Delete check boxes
23
NPI of person delivering the baby
 
24
Method of disposition
 
25
Date of disposition
 
26
Place of disposition
Added
27
Location of disposition - City/town and state
Added
28
Name and complete address of funeral facility
Added
29
Funeral director signature
Added
30
Initiating cause/condition (cause of death)
 
31
Other significant causes or conditions
 
32
Estimated time of fetal death
 
33
Was an autopsy performed?
 
34
Was a histological placental examination performed?
 
35
Were autopsy or histological placental examination results used in determining the cause of death?
 
36
Registrar signature
Added
37
Date received
 
U.S. STANDARD CERTIFICATE OF DEATH
Table 5:
Death Certificate Items
Item Number
Item Name
Difference from U.S. Standard, if any
1
Legal name (include a.k.a. if any)
 
2
Death date
 
3
Sex
 
4a
Age - Years
 
4b
Age - Under 1 year
 
4c
Age - Under 1 day
 
5
Social Security number
 
6
County of death
 
7
Birth date
 
8a
Birth place - City, town or county
 
8b
Birth place - State or foreign country
 
9
Decedent's education
Add "Specify": next to box for "8th Grade or less"
10
Decedent's Hispanic origin
 
11
Decedent's race
 
12
Was decedent ever in U.S. Armed Forces?
 
13a
Residence - Number and street
 
13b
Residence - City or town
 
13c
Residence - County
 
13d
Tribal reservation name (if applicable)
Added
13e
Residence - State or foreign country
 
13f
Residence - Zip code
 
13g
Inside city limits?
 
14
Estimated length of time at residence
Added
15
Marital status at time of death
 
16
Surviving spouse's name
 
17
Occupation
 
18
Kind of business/industry
 
19
Father's name
 
20
Mother's name before first marriage
 
21
Informant - Name
 
22
Informant - Relationship to decedent
 
23
Informant - Address
 
24
Place of death
 
25
Facility name (if not a facility, give number and street)
 
26a
City, town, or location of death
 
26b
State of death
 
27
Zip code of death
 
28
Method of disposition
 
29
Place of disposition (name of cemetery, crematory, other place)
 
30
Disposition - City/town, and state
 
31
Name and complete address of funeral facility
 
32
Date of disposition
Added
33
Funeral director signature
 
34
Causes of death and intervals between onset and death
 
35
Other significant conditions contributing to death
 
36
Autopsy?
 
37
Were autopsy findings available to complete the cause of death?
 
38
Manner of death
 
39
Pregnancy status
 
40
Did tobacco use contribute to death?
 
41
Date of injury
 
42
Hour of injury
 
43
Place of injury
 
44
Injury at work?
 
45
Injury location - Street, city, county, state, zip
County Added
46
Describe how injury occurred
 
47
Transport injury type
 
48a
Certifying physician signature
 
48b
Medical examiner/coroner signature
 
49
Name and address of certifier
 
50
Hour of death
 
51
Name and title of attending physician if other than certifier
Added
52
Date certified
 
53
Title of certifier
 
54
License number of certifier
 
55
ME/coroner file number
Added
56
Was case referred to medical examiner?
 
57
County registrar signature
Added
58
County date received
Added
59
Record amendment
Added
License number of funeral director
Deleted
Date pronounced dead
Deleted
Time pronounced dead
Deleted
Signature of person pronouncing death
Deleted
License number of person pronouncing death
Deleted
Date person pronouncing death signed
Deleted
U.S. STANDARD LICENSE AND CERTIFICATE OF MARRIAGE
Table 6:
Certificate of Marriage
Item Number
Item Name
Difference from U.S. Standard, if any
 
Certificate name
Modified
1
County of license
Added
2
Date valid
 
3
Not valid after (date)
 
4
County auditor signature
 
5
Date received (by county auditor)
 
6a
Person A - Bride/groom/spouse
Added
6b
Legal name before marriage
Modified
6c
Birth name, if different
Added
6d
Sex - Male/female
Added
6e
Current residence (street, city/town)
 
6f
County of residence
 
6g
State of residence
 
6h
Date of birth
 
6i
Birth state (if not USA, provide country)
 
6j
Mother/parent birth name
Modified
6k
Father/parent birth name
Modified
6l
Mother/parent birth state (or country)
Modified
6m
Father/parent birth state (or country)
Modified
7a
Person B - Bride/groom/spouse
Added
7b
Legal name before marriage
 
7c
Birth name, if different
Modified
7d
Sex - Male/female
Added
7e
Current residence (street, city/town)
 
7f
County of residence
 
7g
State of residence
 
7h
Date of birth
 
7i
Birth state (if not USA, provide country)
 
7j
Mother/parent birth name
Modified
7k
Father/parent birth name
Modified
7l
Mother/parent birth state (or country)
Modified
7m
Father/parent birth state (or country)
Modified
8
Date of marriage
 
9
County of ceremony
 
10
Type of ceremony
Added
11
Date signed (by officiant)
Added
12
Officiant's address
 
13
Officiant's daytime phone
Added
14
Officiant's name
 
15
Officiant's signature
 
16
Witness signature
 
17
Witness signature
 
18
Person A signature
Modified
19
Date signed (by person A)
Added
20
Person B signature
Modified
21
Date signed (by person B)
Added
22
Person A - Social Security number
Added
23
Person A - Name
Added
24
Person B - Social Security number
Added
25
Person B - Name
Added
26
Person A signature - Declaration in absence of a Social Security number
Added
27
Person A date - Declaration in absence of a Social Security number
Added
28
Person B signature - Declaration in absence of a Social Security number
Added
29
Person B date - Declaration in absence of a Social Security number
Added
 
(Groom's) age last birthday
Deleted
 
(Bride's) age last birthday
Deleted
 
Signature of (license) issuing official
Deleted
 
Title of (license) issuing official
Deleted
 
Where married - City, town or location
Deleted
 
Title (of officiant)
Deleted
 
Confidential information
Deleted
U.S. STANDARD CERTIFICATE OF DIVORCE, DISSOLUTION OF MARRIAGE, OR ANNULMENT
TABLE 7:
Certification of Dissolution, Declaration of Invalidity of Marriage, or Legal Separation
Item Number
Item Name
Difference from U.S. Standard, if any
 
Certificate name
Modified
1
Court file number
Added
2
Type of decree
 
3
Date of decree
 
4
County where decree filed
 
5
Signature of superior court clerk
 
6a
Spouse A - Name
Added
6b
Birth name, if different
Added
6c
Date of birth
 
6d
Place of birth (state or country)
 
6e
Residence - Street
Added
6f
Residence - City
 
6g
Residence - County
 
6h
Residence - State
 
7a
Spouse B - Name
Added
7b
Birth name, if different
Modify
7c
Date of birth
 
7d
Place of birth (state or country)
 
7e
Residence - Street
Added
7f
Residence - City
 
7g
Residence - County
 
7h
Residence - State
 
8
Place of marriage -County
 
9
Place of marriage - State
 
10
Date of marriage
 
11
Number of children born alive of this marriage
Added
12
Petitioner
 
13
Name of petitioner's attorney or pro se
 
14
Petitioner's attorney's address
 
15
Spouse A Social Security number
Added
16
Spouse B Social Security number
Added
 
Date (decree) recorded
Deleted
 
Number of children under 18 whose physical custody was awarded to (husband, wife, joint, other)
Deleted
 
Number of children under 18 in household
Deleted
 
Title of court
Deleted
 
Title of certifying official
Deleted
 
Date (certifying official) signed
Deleted
 
Date couple last resided in same household
Deleted
 
Confidential items
Deleted
TABLE 8:
Certification of Dissolution of Washington State Domestic Partnership
Item Number
Item Name
 
Certificate name
 
Court file number
1
Type of decree
2
Date of decree
3
County where decree filed
4
Signature of superior court clerk
5a
First partner's name
5b
First partner's name at birth
6
First partner's date of birth
7
First partner's place of birth
8
First partner's residence - Street
9
First partner's residence - City
10
First partner's residence - Inside city limits
11
First partner's residence - County
12
First partner's residence - State
13a
Second partner's name
13b
Second partner's name at birth
14
Second partner's date of birth
15
Second partner's place of birth
16
Second partner's residence - Street
17
Second partner's residence - City
18
Second partner's residence - Inside city limits
19
Second partner's residence - County
20
Second partner's residence - State
21
Date of this partnership
22
Domestic partnership certificate number
23
Petitioner
24
Name of petitioner's attorney/pro se
25
Petitioner's address
[Statutory Authority: RCW 43.70.150 and 26.60.100. WSR 14-04-092, § 246-491-149, filed 2/4/14, effective 3/7/14. Statutory Authority: RCW 43.70.150. WSR 13-01-004, § 246-491-149, filed 12/6/12, effective 12/6/12. Statutory Authority: RCW 26.09.150. WSR 09-11-111, § 246-491-149, filed 5/19/09, effective 6/19/09. Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. WSR 02-20-092, § 246-491-149, filed 10/1/02, effective 11/1/02. Statutory Authority: RCW 43.70.150. WSR 91-23-026 (Order 211), § 246-491-149, filed 11/12/91, effective 12/13/91. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-491-149, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20A.620. WSR 88-19-034 (Order 2696), § 248-124-160, filed 9/12/88.]
(Effective January 1, 2021)

PDF246-491-149

Information collected on the legal or public section of vital records.

The department shall collect the following items on the legal or public section of reports for registration into the statewide vital records system in accordance with chapter 70.58A RCW and this section.
REPORT OF LIVE BIRTH
Table 3:
Legal or Public Birth Record Items
Item Name
Difference from U.S. Standard, if any
Child's name
 
Child's date of birth
 
Time of birth
 
Type of birthplace
Add "En route," Add "Planned birthplace if different"
Child's sex
 
Name of facility
 
City, town or location of birth
 
County of birth
 
Mother/Parent's name before first marriage
 
Mother/Parent's date of birth
 
Mother/Parent's birthplace
 
Mother/Parent's Social Security number
 
Mother/Parent's current legal last name
 
Social Security number requested for child?
 
Mother/Parent's residence - Number, street, and Apt. No.
 
Mother/Parent's residence - City or town
 
Mother/Parent's residence - County
 
Tribal reservation name (if applicable)
Added
Mother/Parent's residence - State or foreign country
 
Mother/Parent's residence - Zip code + 4
 
Mother/Parent's residence - Inside city limits?
 
Telephone number
Added
How long at current residence?
Added
Mother/Parent's mailing address, if different
 
Father/Parent's current legal name
 
Father/Parent's date of birth
 
Father/Parent's birthplace
 
Father/Parent's Social Security number
 
Certifier name and title
Delete check boxes
Date certified
 
Attendant name and title
Delete check boxes
NPI of person delivering the baby
 
REPORT OF FETAL DEATH
Table 4:
Legal or Public Fetal Death Record Items
Item Name
Difference from U.S. Standard, if any
Name of fetus
 
Sex
 
Date of delivery
 
Time of delivery
 
Type of birthplace
Add "En route," Add "Planned birthplace if different"
Name of facility
 
Facility ID (NPI)
 
City, town or location of birth
 
Zip code of delivery
 
County of birth
 
Mother/Parent's name before first marriage
 
Mother/Parent's date of birth
 
Mother/Parent's current legal last name
 
Mother/Parent's birthplace
 
Mother/Parent's residence - Number, street, and Apt. No.
 
Mother/Parent's residence - City or town
 
Mother/Parent's residence - County
 
Tribal reservation name (if applicable)
Added
Mother/Parent's residence - State or foreign country
 
Mother/Parent's residence - Zip code + 4
 
Mother/Parent's residence - Inside city limits?
 
How long at current residence?
Added
Father/Parent's current legal name
 
Father/Parent's date of birth
 
Father/Parent's birthplace
 
Name and title of person completing the report
 
Date report completed
 
Attendant name and title
Delete check boxes
NPI of person delivering the baby
 
Method of disposition
 
Date of disposition
 
Place of disposition
Added
Location of disposition - City/town and state
Added
Name and complete address of funeral facility
Added
Funeral director signature
Added
Initiating cause/condition (cause of death)
 
Other significant causes or conditions
 
Estimated time of fetal death
 
Was an autopsy performed?
 
Was a histological placental examination performed?
 
Were autopsy or histological placental examination results used in determining the cause of death?
 
Registrar signature
Added
Date received
 
REPORT OF DEATH
Table 5:
Death Record Items
Item Name
Difference from U.S. Standard, if any
Legal name (include a.k.a. if any)
 
Death date
 
Sex
Add "X" as nonbinary option
Age - Years
 
Age - Under 1 year
 
Age - Under 1 day
 
Social Security number
 
County of death
 
Birth date
 
Birth place - City, town or county
 
Birth place - State or foreign country
 
Decedent's education
Add "Specify": next to box for "8th Grade or less"
Decedent's Hispanic origin
 
Decedent's race
 
Was decedent ever in U.S. Armed Forces?
 
Residence - Number and street
 
Residence - City or town
 
Residence - County
 
Tribal reservation name (if applicable)
Added
Residence - State or foreign country
 
Residence - Zip code
 
Inside city limits?
 
Estimated length of time at residence
Added
Marital status at time of death
 
Surviving spouse's name
 
Occupation
 
Kind of business/industry
 
Father/Parent's name
 
Mother/Parent's name before first marriage
 
Informant - Name
 
Informant - Relationship to decedent
 
Informant - Address
 
Place of death
 
Facility name (if not a facility, give number and street)
 
City, town, or location of death
 
State of death
 
Zip code of death
 
Method of disposition
 
Place of disposition (name of cemetery, crematory, other place)
 
Disposition - City/town, and state
 
Name and complete address of funeral facility
 
Date of disposition
Added
Funeral director signature
 
Causes of death and intervals between onset and death
 
Other significant conditions contributing to death
 
Autopsy?
 
Were autopsy findings available to complete the cause of death?
 
Manner of death
 
Pregnancy status
 
Did tobacco use contribute to death?
 
Date of injury
 
Hour of injury
 
Place of injury
 
Injury at work?
 
Injury location - Street, city, county, state, zip
County Added
Describe how injury occurred
 
Transport injury type
 
Certifying physician signature
 
Medical examiner/coroner signature
 
Name and address of certifier
 
Hour of death
 
Name and title of attending physician if other than certifier
Added
Date certified
 
Title of certifier
 
License number of certifier
 
ME/coroner file number
Added
Was case referred to medical examiner?
 
County registrar signature
Added
County date received
Added
Record amendment
Added
REPORT OF MARRIAGE
Table 6:
Certification of Marriage
Item Name
Difference from U.S. Standard, if any
Certificate name
Modified
County of license
Added
Date valid
 
Not valid after (date)
 
County auditor signature
 
Date received (by county auditor)
 
Person A - Bride/groom/spouse
Added
Legal name before marriage
Modified
Birth name, if different
Added
Sex
Added
Current residence (street, city/town)
 
County of residence
 
State of residence
 
Date of birth
 
Birth state (if not USA, provide country)
 
Mother/Parent's birth name
Modified
Father/Parent's birth name
Modified
Mother/Parent's birth state (or country)
Modified
Father/Parent's birth state (or country)
Modified
Person B - Bride/groom/spouse
Added
Legal name before marriage
 
Birth name, if different
Modified
Sex
Added
Current residence (street, city/town)
 
County of residence
 
State of residence
 
Date of birth
 
Birth state (if not USA, provide country)
 
Mother/Parent's birth name
Modified
Father/Parent's birth name
Modified
Mother/Parent's birth state (or country)
Modified
Father/Parent's birth state (or country)
Modified
Date of marriage
 
County of ceremony
 
Type of ceremony
Added
Date signed (by officiant)
Added
Officiant's address
 
Officiant's daytime phone
Added
Officiant's name
 
Officiant's signature
 
Witness signature
 
Witness signature
 
Person A signature
Modified
Date signed (by person A)
Added
Person B signature
Modified
Date signed (by person B)
Added
Person A - Social Security number
Added
Person A - Name
Added
Person B - Social Security number
Added
Person B - Name
Added
Person A signature - Declaration in absence of a Social Security number
Added
Person A date - Declaration in absence of a Social Security number
Added
Person B signature - Declaration in absence of a Social Security number
Added
Person B date - Declaration in absence of a Social Security number
Added
REPORT OF DIVORCE, DISSOLUTION OF MARRIAGE, OR ANNULMENT
Table 7:
Certification of Dissolution, Declaration of Invalidity of Marriage, or Legal Separation
Item Name
Difference from U.S. Standard, if any
Certificate name
Modified
Court file number
Added
Type of decree
 
Date of decree
 
County where decree filed
 
Signature of superior court clerk
 
Spouse A - Name
Added
Birth name, if different
Added
Date of birth
 
Place of birth (state or country)
 
Residence - Street
Added
Residence - City
 
Residence - County
 
Residence - State
 
Spouse B - Name
Added
Birth name, if different
Modify
Date of birth
 
Place of birth (state or country)
 
Residence - Street
Added
Residence - City
 
Residence - County
 
Residence - State
 
Place of marriage -County
 
Place of marriage - State
 
Date of marriage
 
Number of children born alive of this marriage
Added
Petitioner
 
Name of petitioner's attorney or pro se
 
Petitioner's attorney's address
 
Spouse A Social Security number
Added
Spouse B Social Security number
Added
Table 8:
Certification of Dissolution of Washington State Domestic Partnership
Item Name
Certificate name
Court file number
Type of decree
Date of decree
County where decree filed
Signature of superior court clerk
First partner's name
First partner's name at birth
First partner's date of birth
First partner's place of birth
First partner's residence - Street
First partner's residence - City
First partner's residence - Inside city limits
First partner's residence - County
First partner's residence - State
Second partner's name
Second partner's name at birth
Second partner's date of birth
Second partner's place of birth
Second partner's residence - Street
Second partner's residence - City
Second partner's residence - Inside city limits
Second partner's residence - County
Second partner's residence - State
Date of this partnership
Domestic partnership certificate number
Petitioner
Name of petitioner's attorney/pro se
Petitioner's address
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-149, filed 6/5/20, effective 1/1/21. Statutory Authority: RCW 43.70.150 and 26.60.100. WSR 14-04-092, § 246-491-149, filed 2/4/14, effective 3/7/14. Statutory Authority: RCW 43.70.150. WSR 13-01-004, § 246-491-149, filed 12/6/12, effective 12/6/12. Statutory Authority: RCW 26.09.150. WSR 09-11-111, § 246-491-149, filed 5/19/09, effective 6/19/09. Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. WSR 02-20-092, § 246-491-149, filed 10/1/02, effective 11/1/02. Statutory Authority: RCW 43.70.150. WSR 91-23-026 (Order 211), § 246-491-149, filed 11/12/91, effective 12/13/91. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-491-149, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20A.620. WSR 88-19-034 (Order 2696), § 248-124-160, filed 9/12/88.]



(Effective January 1, 2021)

PDF246-491-159

Items on birth and death certifications and informational copies.

Certifications and informational copies of birth and death records issued from the state vital records system must contain only items in accordance with this section.
(1) Unless the items are not available or were not collected at the time of birth registration, certifications of birth, certifications of delayed birth, and informational copies of birth and delayed births will display only the following items:
Vital Record Item
Certification of Birth and Informational Birth Copy
Certification of Delayed Birth and Informational Delayed Birth Copy
State file number
Yes
Yes
Date certificate issued
Yes
Yes
First and middle name(s) of subject of the record
Yes
Yes
Last name(s) of subject of the record
Yes
Yes
Date of birth of subject of the record
Yes
Yes
Facility born
Yes
Yes
Place of birth (city, county, state)
Yes
Yes
Time of birth
Yes
Yes
Sex
Yes
Yes
Mother/parent's name prior to first marriage
Yes
Yes
Mother/parent's place of birth
Yes
Yes
Mother/parent's date of birth or age at the time of child's birth
Yes
Yes
Father/parent's current legal name
Yes
Yes
Father/parent's place of birth
Yes
Yes
Father/parent's date of birth or age at the time of child's birth
Yes
Yes
Evidence required by RCW 70.58A.120, 70.58A.130, and WAC 246-490-081
No
Yes
Date record filed
Yes
Yes
Fee number
Yes
Yes
Signature of applicant
No
Yes
(2)(a) For deaths registered starting January 1, 2018, long form certifications of death, short form certifications of death, and informational copies of death will display only the following items:
Vital Record Item
Long Form Certification of Death
Short Form Certification of Death
Informational Copy of Death
State file number
Yes
Yes
Yes
Date certificate issued
Yes
Yes
Yes
Fee number
Yes
Yes
Yes
Decedent's legal first and middle name(s)
Yes
Yes
Yes
Decedent's last name(s)
Yes
Yes
Yes
County of death
Yes
Yes
Yes
Date of death
Yes
Yes
Yes
Hour of death
Yes
Yes
Yes
Sex
Yes
Yes
Yes
Age
Yes
Yes
Yes
Social Security number
Yes
No
No
Place of death
Yes
Yes
Yes
Facility or address of death
Yes
Yes
Yes
City, state, zip
Yes
Yes
Yes
Hispanic origin
Yes
Yes
Yes
Race
Yes
Yes
Yes
Residence street
Yes
Yes
Yes
Residence city, state, zip
Yes
Yes
Yes
Residence county
Yes
Yes
Yes
Is residence inside city limits?
Yes
Yes
Yes
Tribal reservation
Yes
Yes
Yes
Length of time at residence
Yes
Yes
Yes
Birth date
Yes
Yes
Yes
Birthplace
Yes
Yes
Yes
Father/parent name
Yes
Yes
Yes
Mother/parent name
Yes
Yes
Yes
Martial status
Yes
Yes
Yes
Spouse
Yes
Yes
Yes
Method of disposition of remains
Yes
Yes
Yes
Place of disposition of remains
Yes
Yes
Yes
City, state of disposition of remains
Yes
Yes
Yes
Disposition date of remains
Yes
Yes
Yes
Occupation
Yes
Yes
Yes
Industry
Yes
Yes
Yes
Education
Yes
Yes
Yes
U.S. Armed Forces
Yes
Yes
Yes
Informant name
Yes
Yes
Yes
Informant's relationship to decedent
Yes
Yes
Yes
Informant's address
Yes
Yes
Yes
Funeral facility
Yes
Yes
Yes
Funeral facility address
Yes
Yes
Yes
Funeral facility city, state, zip
Yes
Yes
Yes
Funeral director name
Yes
Yes
Yes
Cause of death (A, B, C, and D)
Yes
No
No
Other conditions contributing to death
Yes
No
No
Date of injury
Yes
No
No
Hour of injury
Yes
No
No
Injury at work
Yes
No
No
Place of injury
Yes
No
No
Location of injury
Yes
No
No
City, state, zip of injury
Yes
No
No
County of injury
Yes
No
No
Describe how the injury occurred
Yes
No
No
If transportation injury, specify
Yes
No
No
Manner of death
Yes
No
No
Autopsy
Yes
No
No
Were autopsy findings available to complete cause of death?
Yes
No
No
Did tobacco use contribute to death?
Yes
No
No
Pregnancy status if female
Yes
No
No
Certifier name
Yes
No
No
Certifier title
Yes
No
No
Certifier address
Yes
No
No
Certifier city, state, zip
Yes
No
No
Date signed by certifier
Yes
No
No
Case referred to ME/coroner?
Yes
No
No
File number
Yes
No
No
Attending physician
Yes
No
No
Local deputy registrar
Yes
Yes
Yes
Date received by local deputy registrar
Yes
Yes
Yes
(b) For deaths registered before January 1, 2018, long form certifications of death will contain only the vital record items as indicated for long form certification in (a) of this subsection if such vital record items are available or were collected at the time of death registration.
(c) For deaths registered before January 1, 2018, informational copies of death will contain only the vital record items as indicated for informational death copy in (a) of this subsection if such vital record items are available or were collected at the time of death registration.
(d) The short form certification of death is not available for deaths registered before January 1, 2018.
(3) Certification of fetal death will display only the following items:
Vital Record Item
Local file number
State file number
Name of fetus (first, middle, last, suffix)
Sex
Date of delivery
Time of delivery
Type of birthplace
Planned birthplace, if different
Name of facility
Facility I.D.
City, town, or location of delivery
Zip code of delivery
County of delivery
Mother's name before first marriage (first, middle, last)
Mother's date of birth
Mother's current legal last name, if different
Mother's birthplace (state, territory, or foreign country)
Mother's residence - Number and street
Mother's residence - Apt no.
Mother's residence - City or town
Mother's residence - County
If you live on tribal reservation, give name
State or foreign country
Zip code +4
Mother's residence inside city limits
How long at current residence?
Name and title of person completing cause of death
Signature of person completing cause of death
Date signed by person completing cause of death
Name and title of person delivering the fetus
NPI of person delivering the fetus
Method of disposition
Date of disposition
Place of disposition
Disposition location - City/town, and state
Name and complete address of funeral facility
Funeral director signature
Initiating cause/condition
Other significant causes or conditions
Estimated time of fetal death
Was an autopsy performed?
Was a histological placental examination performed?
Registrar signature
Date received by local registrar
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-159, filed 6/5/20, effective 1/1/21.]



(Effective January 1, 2021)

PDF246-491-300

Requirements for ordering certifications of birth, death, and fetal death.

(1) For certifications of birth, death, and fetal death, the state or local registrar shall release certifications only to qualified applicants as permitted by chapter 70.58A RCW.
(2) For each application, the qualified applicant must submit all of the following:
(a) Information to correctly identify the record consistent with the requirements of WAC 246-491-310;
(b) Identity documentation consistent with the requirements of WAC 246-491-320;
(c) Evidence of eligibility consistent with the requirements of WAC 246-491-330; and
(d) Fees required by RCW 70.58A.560 and WAC 246-491-990, or evidence that the qualified applicant is eligible to receive certifications of a vital record at no charge as required by WAC 246-491-350.
(3) All identity documentation and evidence of eligibility documentation submitted to the state or local registrar from the applicant must originate from a source which the state or local registrar can reasonably verify the authenticity of the documentation.
(4) The applicant must submit all required information and documentation to the state or local registrar within thirty days of the state or local registrar requesting additional information. After thirty days, the application is considered denied.
(5) When the applicant cannot submit the required information or documentation, the applicant will be given an opportunity through an exception process to explain the circumstances to the state or local registrar. If the circumstances presented would have prevented the applicant from providing items required by this section, the state or local registrar may grant an exception and issue the record.
(6) The state or local registrar may deny an application if the applicant fails to meet the requirements of this section or chapter 70.58A RCW. If the state registrar denies an application for failing to meet the requirements, the applicant may appeal the decision by requesting a brief adjudicative proceeding pursuant to WAC 246-10-501 through 246-10-505, and RCW 70.58A.550.
(7) For the purpose of this section:
(a) "Application" means a documented request for certifications of birth, death, and fetal death, including short form certifications of death where applicable.
(b) "Birth" includes delayed birth.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-300, filed 6/5/20, effective 1/1/21.]



(Effective January 1, 2021)

PDF246-491-310

Information required to order certifications of birth, death, and fetal death.

(1) A qualified applicant requesting a certification of birth must submit the following information as it appears on the birth record on a form provided by the state or local registrar:
(a) First, middle, and last name of the subject of the record;
(b) First and last name of all parents listed on the record;
(c) Date of birth; and
(d) City or county where the birth occurred.
(2) A qualified applicant requesting a certification of death must submit the following information on a form provided by the state or local registrar:
(a) First and last name of the decedent as it appears on the record;
(b) Approximate date of death; and
(c) City or county where the death occurred.
(3) For the purpose of this section:
(a) "Birth" includes delayed birth.
(b) "Death" includes fetal death.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-310, filed 6/5/20, effective 1/1/21.]



(Effective January 1, 2021)

PDF246-491-320

Identity documentation required to obtain certifications of birth, death, and fetal death.

(1) The qualified applicant must submit identity documentation to the state or local registrar to receive a certification of birth, death, or fetal death in accordance with this section.
(2)(a) The qualified applicant must submit to the state or local registrar one of the following pieces of identity documentation, valid or expired no more than sixty days that contains the applicant's full name, photograph, and date of birth:
(i) Enhanced driver's license, driver's license, or instruction permit issued by a state or territory of the United States, or the District of Columbia;
(ii) A Washington state identification card or an identification card issued by another state;
(iii) A military identification card;
(iv) A United States passport or passport card; or
(v) An identification document issued by local, state, federal, or foreign government, or federally recognized Indian tribe.
(b) A qualified applicant requesting on behalf of a government agency or courts to conduct official duties may use an identification card issued by their government agency or courts that contains the full name and photograph of the applicant.
(3) If a qualified applicant is unable to submit one identity documentation listed in subsection (2) of this section, they must provide at least two alternate forms of identification. Alternate forms of identification may include, but are not limited to, government issued identifications listed in subsection (2)(a) of this section if expired more than sixty days, letters from government or social agencies, pay statements, utility bills, student identification with photo, or other items acceptable to the state registrar. Alternate forms of identification must at least contain matching first and last names and addresses, or provide the full name, photograph, and date of birth.
(4) For applications received by telephone or internet, the qualified applicant may choose to take an authentication quiz in lieu of submitting identity documents. The authentication quiz must contain or ask information requiring personal knowledge not available from reviewing current information typically found in their wallet or personal possession. If the authentication quiz is not successfully completed, the applicant must submit identity documentation listed in subsection (1) or (2) of this section.
(5) Proof of citizenship is not required information to receive a certification of birth, death, or fetal death.
(6) For the purpose of this section, "birth" includes delayed birth.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-320, filed 6/5/20, effective 1/1/21.]



(Effective January 1, 2021)

PDF246-491-330

Evidence of eligibility.

(1) The qualified applicant must submit evidence of eligibility documents to the state or local registrar to prove they are eligible to receive a certification of birth, death, or fetal death.
(2) If the qualified applicant is listed as a party on the record, and their identity documentation provided in WAC 246-491-320 sufficiently links the applicant to the record, then evidence of eligibility is met.
(3) If the qualified applicant is not listed as a party on the record or the identity documentation does not sufficiently link the qualified applicant to the record, the following documentation may serve as evidence of eligibility:
(a) Copies of vital records such as certifications of birth, death, marriage, and divorce from this or another jurisdiction that link the applicant to the requested record;
(b) Copies of certified court orders from a court of competent jurisdiction linking the applicant to the record;
(c) Document or letter from title insurer or title insurance agent handling a transaction on behalf of the decedent;
(d) Document or letter from a government agency or courts stating the certification will be used in the conduct of official duties; or
(e) Other documents that link the applicant to the record as determined by the state registrar.
(4) For the purpose of this section, "birth" includes delayed birth.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-330, filed 6/5/20, effective 1/1/21.]



(Effective January 1, 2021)

PDF246-491-340

Requirements for ordering certifications of marriage, dissolution of marriage, and dissolution of domestic partnership.

(1) To receive a certification of marriage, dissolution of marriage, or dissolution of domestic partnership, the applicant must submit to the state registrar:
(a) Information to correctly identify the record requested consistent with the requirements of (c) of this subsection;
(b) Fees required by RCW 70.58A.560 and WAC 246-491-990; and
(c) The following information on a form provided by the state registrar:
(i) First and last name of one of the parties on the record;
(ii) Approximate date the event occurred; and
(iii) City or county where the event was filed.
(2) The state registrar may require the first and last name of the second party on the record to ensure the correct record was located.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-340, filed 6/5/20, effective 1/1/21.]



(Effective January 1, 2021)

PDF246-491-350

Requirements for certifications of vital records at no charge.

(1) Qualified applicants requesting a certification at no charge per RCW 70.58A.560 (2) and (3) must provide identity documentation, eligibility documentation, and required information to the state or local registrar in accordance with RCW 70.58A.530 and this chapter, in addition to the requirements of this section.
(2) To qualify for a certification of death at no charge per RCW 70.58A.560(2):
(a) A law enforcement agency must submit a letter on official letterhead to the state or local registrar stating the certification will be used to maintain a registered sex offender database; or
(b) A county clerk or court in the state must submit a letter on official letterhead to the state or local registrar stating the certification will be used to extinguish an offender's legal financial obligation.
(3) To qualify for a certification at no charge pending a veterans administration claim per RCW 70.58A.560 (2)(a), the state or local registrar must receive:
(a) A letter on official letterhead from the veterans administration stating the certification will be used in connection with a claim for compensation or pension;
(b) A letter on official letterhead from the veterans administration stating an agency is working on behalf of the veterans administration, authorized to represent the veteran, provides the claim type currently pending before the veterans administration, and identifies the type of certification needed;  
(c) A letter on official letterhead from the veterans administration stating there is currently a claim pending before the veterans administration, identifies the type of certification needed, and is submitted by a spouse or dependent of the eligible veteran; or
(d) A letter on official letterhead from the veterans administration stating the decedent is eligible for veterans administration burial benefits or approved to be buried in a national cemetery and is submitted by a funeral home or director.
(4) To qualify for a certification of birth at no charge for a homeless person living in state per RCW 70.58A.560(3), a government agency or homeless services provider working on behalf of the homeless individual must submit a letter on official letterhead to the state registrar asserting the individual meets the definition of homeless and lives in the state.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-350, filed 6/5/20, effective 1/1/21.]



(Effective January 1, 2021)

PDF246-491-360

Requirements for ordering informational copies of birth and death records.

(1) To receive an informational copy of a birth or death record, the applicant must submit to the state or local registrar:
(a) Information to correctly identify the record on a form provided by the state or local registrar consistent with the requirements of (c) or (d) of this subsection; and
(b) Fees required by RCW 70.58A.560 and WAC 246-491-990;
(c) For an informational copy of a birth record, the following information as it appears on the record:
(i) First, middle, and last name of the subject of the record;
(ii) First and last name of all parents listed on the record;
(iii) Date of birth; and
(iv) City or county where the birth occurred.
(d) For an informational copy of a death record, the following information:
(i) First and last name of the decedent;
(ii) Approximate date of death; and
(iii) City or county where the death occurred.
(2) For the purpose of this section, "birth" includes delayed birth.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-360, filed 6/5/20, effective 1/1/21.]



(Effective January 1, 2021)

PDF246-491-370

Notification of no record.

(1) The applicant will receive a written notice of no record found if the state or local registrar cannot find a record based on information provided by the applicant. The application request will be considered closed after the written notice is sent. Following such notice, the applicant may do any of the following:
(a) Submit a new application providing different information and pay the fees required by RCW 70.58A.560 and WAC 246-491-990 on this new application; or
(b) If requesting a certification of birth, begin the process to obtain a delayed registration of live birth pursuant to RCW 70.58A.120 and WAC 246-490-080.
(2) Written notification by the state registrar of no record found does not constitute a denial or withholding of a request for the purpose of RCW 70.58A.550.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-370, filed 6/5/20, effective 1/1/21.]



(Effective until January 1, 2021)

PDF246-491-990

Vital records fees.

The department shall collect nonrefundable fees to cover program costs as follows:
(1) To prepare a sealed record following an adoption or to search the vital records system for adoption record information.
$15.00
(2) To file an assertion of parentage, an acknowledgment or denial of parentage, or a rescission of parentage.
$18.00
(3) Fee for hospital filed acknowledgments or denials of parentage.
$5.00
(4) To prepare a certificate of birth record information (CBRI) letter or to provide a copy of an assertion of parentage, an acknowledgment or denial of parentage, or a rescission of parentage.
$15.00
(5) The secretary of health may enter into agreements with state and local government agencies to establish alternate fee schedules and payment arrangements for reimbursement of these program costs.
[Statutory Authority: Chapters 26.26A and 26.26B RCW, and RCW 43.70.150. WSR 19-02-087, § 246-491-990, filed 1/2/19, effective 1/2/19. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-491-990, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 26.33.330. WSR 88-15-011 (Order 2650), § 440-44-095, filed 7/8/88; WSR 85-04-023 (Order 2199), § 440-44-095, filed 1/30/85.]
(Effective January 1, 2021)

PDF246-491-990

Vital records fees.

(1) The department shall collect nonrefundable fees to cover program costs as follows:
To prepare a sealed record following an adoption or to search the vital records system for adoption record information.
$15.00
To file an assertion of parentage, an acknowledgment or denial of parentage, or a rescission of parentage.
$18.00
Fee for hospital filed acknowledgments or denials of parentage.
$5.00
To prepare a certificate of birth record information (CBRI) letter or to provide a copy of an assertion of parentage, an acknowledgment or denial of parentage, or a rescission of parentage.
$15.00
Priority processing fee for applications of certifications and informational copies received by telephone or internet.
$7.00
Priority processing fee for applications of certifications and informational copies received in-person.
$13.50
(2) The secretary of health may enter into agreements with state and local government agencies to establish alternate fee schedules and payment arrangements for reimbursement of these program costs.
(3) The fee for each electronic verification of a vital event through the electronic verification of vital events system must be in accordance with the national pricing model.
[Statutory Authority: 2019 c 148. WSR 20-13-017, § 246-491-990, filed 6/5/20, effective 1/1/21. Statutory Authority: Chapters 26.26A and 26.26B RCW, and RCW 43.70.150. WSR 19-02-087, § 246-491-990, filed 1/2/19, effective 1/2/19. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-491-990, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 26.33.330. WSR 88-15-011 (Order 2650), § 440-44-095, filed 7/8/88; WSR 85-04-023 (Order 2199), § 440-44-095, filed 1/30/85.]