Washington State Department of Health - Vital Records Forms · Washington state form
DOH 422-143 Request to Change Sex Designation on a Birth Certificate for an Adult
Use DOH 422-143 to request a change to the sex designation on an adult’s Washington birth certificate. The request form must be signed before a notary.
- What this form is
- This Washington State Department of Health form is for an adult born in Washington who wants to change the sex designation on their birth certificate. The applicant provides identifying and birth information, indicates the current and requested designations, and signs the request before a notary. Emancipated minors and guardians acting for an adult must include the proof described in the instructions. There is no fee to amend the record.
- Who needs it
- An adult born in Washington who wants to change the sex designation on their birth certificate needs this form.
- Why it needs a notary
- The request must be signed in the presence of a notary. You can complete the notarization online with a commissioned online notary.
- How to submit it
- Mail the completed form to Center for Health Statistics, Department of Health, PO Box 47814, Olympia, WA 98504. Include any required supporting documents.
Questions
Who can use DOH 422-143?
An adult born in Washington who wants to change the sex designation on their birth certificate may use this form. The instructions also address emancipated minors and guardians acting on behalf of an adult.
Does this form need to be notarized?
Yes. The form says the request must be signed in the presence of a Notary Public. You can complete the notarization online with a commissioned online notary.
Where do I mail the completed form?
Mail it to Center for Health Statistics, Department of Health, PO Box 47814, Olympia, WA 98504. The form says to include required documents referenced in its instructions.