Washington State Department of Health - Vital Records Forms · Washington state form
Assertion of Parentage DOH 422-165
Use this form to assert parentage after marrying or entering a state registered domestic partnership with a child’s birth parent after the child’s birth.
- What this form is
- The Assertion of Parentage is a legal form used to create a presumption of parentage. The person asserting parentage completes the form and signs in the presence of either a notarial officer or a qualified witness. Filing it does not add a parent to the child’s birth certificate. The form includes statements about the legal effects of filing and instructions for submitting it to the Department of Health.
- Who needs it
- A person who married or became state registered domestic partners with a child’s birth parent after the child was born may file this form.
- Why it needs a notary
- The signature must be witnessed by either a notarial officer or a qualified witness; it need not be notarized if witnessed. You can sign online with a commissioned online notary.
- How to submit it
- Submit the completed form with a non-refundable $18 check or money order payable to DOH. Send the form and payment to the Department of Health, Center for Health Statistics, PO Box 9709, Olympia, WA 98507.
Questions
Who can file an Assertion of Parentage?
A person who married or became state registered domestic partners with the child’s birth parent after the child was born may file this form.
Does filing this form add a parent to the child’s birth certificate?
No. The form states that filing an Assertion of Parentage does not add a parent to the child’s birth certificate. Further steps may be needed to establish a parent-child relationship.
Does the Assertion of Parentage need a notary?
The person must sign before either a notarial officer or a qualified witness. Notarization is not required if a qualified witness observes the signature. You can sign online with a commissioned online notary.