Washington Application to Amend a Death Certificate (DOH 422-311)
Official state formCorrections and amendmentsForm DOH 422-311Free downloadLast verified November 10, 2026
Use this application to fix mistakes or update items on a Washington death certificate. It is mailed to the Center for Health Statistics at the Washington State Department of Health. It cannot change the cause of death, the day and time of death, or the disposition.
Who can use this form
- The informant listed on the certificate
- The surviving spouse or registered domestic partner listed on the certificate
- A parent, sibling, adult child or stepchild, or next of kin as defined in RCW 11.28.120
- A legal representative: a licensed attorney for the person who died or for one of the people listed above
- Cause of death and disposition changes can only be requested by the medical certifier or the funeral facility
What to send with it
- Pages 3 and 4 of the application, filled out in blue or black ink
- A copy of a government-issued photo ID for every person who signs the application
- Supporting proof documents that show the full name and date of birth of the person whose information is being amended
- Proof that you qualify to ask for the amendment, if needed
- Optional: a certificate issued within the last year for a free exchange, or a certificate order form with payment
Where to send it
- Mail to
- Center for Health Statistics Attn: Amendments PO Box 47814 Olympia, WA 98504-7814
- State fee
- Not provided
- Typical processing
- 4 to 6 weeks, per the office's amendment page
- Form revision
- November 2026
- Source
- Official government page