Washington State Department of Health - Vital Records Forms · Washington state form
DOH 422-157 Rescission of Parentage
Use this form to rescind an Acknowledgment of Parentage or Denial of Parentage. The signer must sign before either a notary or a qualified witness.
- What this form is
- The Rescission of Parentage form lets a person who signed an Acknowledgment of Parentage or Denial of Parentage withdraw it. The form must be completed and filed within 60 days after the AOP or DOP is filed, or before the first court proceeding to adjudicate parentage, whichever happens first. The signer must sign in front of either a notary or a witness, not both.
- Who needs it
- A person who signed an Acknowledgment of Parentage or Denial of Parentage and wants to rescind it within the form’s allowed filing period needs this form.
- Why it needs a notary
- A notary or qualified witness must verify the signature; either option is allowed, not both. Notarization can be done online with a commissioned online notary.
- How to submit it
- Send the completed form with a non-refundable $18 check or money order payable to DOH to Department of Health, Center for Health Statistics, PO Box 9709, Olympia, WA 98507.
Questions
Who can sign the Rescission of Parentage form?
Only the person who signed the Acknowledgment of Parentage or Denial of Parentage form can sign this rescission.
Does the form need to be notarized?
The signer must sign before either a notary or a witness, not both. If choosing notarization, the signature can be notarized online with a commissioned online notary.
How do I submit the completed form?
Send the completed form with a non-refundable $18 check or money order payable to DOH to the Department of Health, Center for Health Statistics, PO Box 9709, Olympia, WA 98507.