Washington Death Certificate Application (Form 422-184) (422-184)
Official state formForm 422-184Free downloadLast verified November 9, 2026
Form DOH 422-184 is the mail order form to request a certified copy of a Washington death certificate. It is filed with the Washington State Department of Health, Center for Health Statistics.
Who can use this form
- A spouse or domestic partner, child, parent, stepparent, stepchild or sibling
- A grandparent, grandchild, great-grandparent or great-grandchild
- A legal guardian, legal representative or authorized representative
- A funeral director listed on the record, within 12 months of the death
- A government agency or court, for official duties only
What to send with it
- The completed and signed order form
- A copy of your identity document (not the original)
- A copy of your proof of eligibility, if your ID does not link you to the record
- The fee by check or money order payable to DOH
Where to send it
- Mail to
- Department of Health Center for Health Statistics PO Box 9709 Olympia, WA 98507-9709
- State fee
- Not provided
- Typical processing
- About 8 to 10 weeks
- Source
- Official government page