Washington Rescission of Parentage (DOH 422-157)
Official state formParentage and paternityForm DOH 422-157Free downloadLast verified November 10, 2026
A person who signed an Acknowledgment or Denial of Parentage uses this legal form to withdraw it. It must be filed with the Center for Health Statistics at the Washington State Department of Health within 60 days of filing or before the first court proceeding, whichever is first.
Who can use this form
- A person who signed the Acknowledgment of Parentage or the Denial of Parentage
- It must be filed within 60 days after that form was filed, or before the first court proceeding about the child's parentage, whichever happens first
- The rescinding party signs in front of a notarial officer or a witness, not both
What to send with it
- The completed form, filled out in ink and not altered
- The $18 non-refundable filing fee, by check or money order payable to DOH
- Optional: $25 for a birth certificate, as printed on the form
Where to send it
- Mail to
- Center for Health Statistics P.O. Box 9709 Olympia, WA 98507
- State fee
- $18 filing fee; $25 for a birth certificate.
- Typical processing
- Not provided
- Form revision
- January 2021
- Source
- Official government page