Washington Assertion of Parentage (DOH 422-165)
Official state formParentage and paternityForm DOH 422-165Free downloadLast verified November 10, 2026
A person who married or entered a state registered domestic partnership with the birth parent after the child was born uses this form to assert parentage. It is filed with the Center for Health Statistics at the Department of Health. Filing it does not add a person to a birth certificate.
Who can use this form
- A person who married or entered into a state registered domestic partnership with the individual who gave birth, after the birth of the child
- The signer 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
- A non-refundable $18 check or money order payable to DOH
Where to send it
- Mail to
- Center for Health Statistics P.O. Box 9709 Olympia, WA 98507
- State fee
- $18 filing fee.
- Typical processing
- Not provided
- Form revision
- March 2021
- Source
- Official government page