HTML has links - PDF has Authentication
246-491-149  <<  246-491-159 >>   246-491-300

(Effective January 1, 2021)

PDFWAC 246-491-159

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.]
Site Contents
Selected content listed in alphabetical order under each group