Washington Acknowledgment of Parentage (DOH 422-159)
Official state formParentage and paternityForm DOH 422-159Free downloadLast verified November 10, 2026
This legal form establishes parentage without a court proceeding. Once it is signed and filed with the Center for Health Statistics at the Washington State Department of Health, the parent's name is added to the child's birth record.
Who can use this form
- The birth parent (mother) and the other parent (father), who both sign the form
- Each signer affirms that no other individual can legally claim parentage of the child
- Each parent signs in front of a notarial officer or a third party witness, not both
- A witness must be at least 18 and not related by blood or marriage to the signers
What to send with it
- The completed form, filled out in ink and not altered, with items 1 to 29
- Both signatures, each notarized or witnessed
- The $18 non-refundable filing fee, by check or money order payable to DOH
- Optional: a Birth Certificate Order form with $25 and a copy of the requestor's ID
Where to send it
- Mail to
- Center for Health Statistics P.O. Box 9709 Olympia, WA 98507
- State fee
- $18 filing fee. No payment is required when parents return the form to the hospital within 5 days of birth.
- Typical processing
- Not provided
- Form revision
- March 2021
- Source
- Official government page