Assertion

What is an Assertion of Parentage form?

An Assertion of Parentage form is a legal form that is used to create a presumption of parentage. This form does not add a parent to a child's birth certificate.

Assertion form (DOH 422-165) (English) (PDF)

Who can file an Assertion of Parentage form?

A person who married or became state domestic partners with the mother/birth parent of the child after the birth of a child. The mother/birth parent's signature is not required.

When is an Assertion required?

An Assertion is required if an individual gets married after the child was born to the person that gave birth. Once the Assertion is filed with the Department of Health, the spouse qualifies to sign an Acknowledgment of Parentage (AOP) form. The spouse needs to be considered a presumed parent, genetically related, or intended parent through assisted reproduction prior to the marriage, according to chapter 26.26A RCW, to sign the AOP without an Assertion.

What are my next steps after filing an Assertion?

There are only three ways to be listed as a parent on the child's birth certificate after filing an Assertion form.

If the mother/birth parent is willing to sign an Acknowledgment of Parentage (AOP) form and no second parent is listed on the child's birth certificate, complete and file an AOP form. For more information on how to file an AOP form, visit the Acknowledgment of Parentage page.
If two parents are currently listed on the child's birth certificate, the individual who filed an Assertion may file an AOP form, but the second parent must submit a Denial of Parentage (DOP) form to be removed from the birth certificate. For more information on how to file a DOP form, visit the Denial of Parentage page.
If anyone disagrees or will not sign an AOP or DOP form, a court order is required. For more information on court orders, visit the Court Order webpage.

Instructions for completing the Assertion of Parentage form

The individual asserting parentage must sign page 1 in the presence of a notary or witness.
The notary or witness must sign on page 1.
Submit completed Assertion of Parentage form with a non-refundable $18 check or money order payable to DOH.

If the Assertion and AOP forms are submitted together, two non-refundable $18 filing fees are required.

Mail In-Person

By Mail

Mailing Address

Send all forms and payments to:

Department of Health
Center for Health Statistics
PO Box 9709
Olympia, WA 98507

Do I need a notary or a witness?

Yes. The person asserting parentage must sign in front of either a notary OR a witness. The notary or witness must also complete the signature block.

Common notary locations include hospitals, local banks, title companies, and attorneys/county clerks.

A person signing the witnessed statement must be at least 18 years of age and not related by blood or marriage to the individuals who sign an Assertion of Parentage form. The local child support offices will serve as witnesses. Center for Health Statistics staff will not serve as witnesses.

Ordering a certificate with a correction request

Send completed certificate order form with your correction request. Include all required documents referenced on the certificate application instruction page.
Certificate will be issued after the correction has been processed.

Birth Certificate Application (en español)

Death Certificate Application (en español)

Marriage & Divorce Application (en español)

Exchanging a certificate with a correction request

If you currently have a certified copy of a certificate that was issued less than one year ago, send in the certified copy of the certificate with your correction request; we will exchange the certificate at no charge.

More information

For more information, visit our Frequently Asked Questions page