Washington State Department of Health - Vital Records Forms · Washington state form
Denial of Parentage DOH 422-158
Use this form to deny parentage for a child when everyone agrees and parentage has not been decided by a court. It must be filed with an Acknowledgment of Parentage.
- What this form is
- A presumed or alleged genetic parent uses this legal form to deny parentage and be removed from the child’s birth certificate. The Denial of Parentage must be filed with a valid Acknowledgment of Parentage, signed by the birth parent and the person seeking to establish parentage. The signer must sign in front of either a notary or a qualifying witness, who also completes the signature block.
- Who needs it
- A presumed or alleged genetic parent may use this form when everyone agrees and a court has not decided parentage. An Acknowledgment of Parentage is also required.
- Why it needs a notary
- The signer must sign before either a notary or a qualifying witness. Notarization can be done online with a commissioned online notary; a witness is an alternative.
- How to submit it
- Submit 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.
Questions
Who can use the Denial of Parentage form?
A presumed or alleged genetic parent may use it when everyone agrees and parentage has not been decided by a court. A valid Acknowledgment of Parentage must also be filed.
Does the Denial of Parentage form need to be notarized?
The signer must sign in front of either a notary or a qualifying witness, not both. Online notarization is available with a commissioned online notary; the form also permits a qualifying witness.
How do I submit DOH 422-158?
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.