WAC 246-491-159. Items on birth and death certifications and informational copies

Certifications and informational copies of birth and death records issued from the state vital records system must contain only items in accordance with this section. (1) Unless the items are not available or were not collected at the time of birth registration, certifications of birth, certifications of delayed birth, and informational copies of birth and delayed births will display only the following items: Vital Record Item Certification of Birth and Informational Birth Copy Certification of Delayed Birth and Informational Delayed Birth Copy State file number Yes Yes Date certificate issued Yes Yes First and middle name(s) of subject of the record Yes Yes Last name(s) of subject of the record Yes Yes Date of birth of subject of the record Yes Yes Facility born Yes Yes Place of birth (city, county, state) Yes Yes Time of birth Yes Yes Sex Yes Yes Mother/parent's name prior to first marriage Yes Yes Mother/parent's place of birth Yes Yes Mother/parent's date of birth or age at the time of child's birth Yes Yes Father/parent's current legal name Yes Yes Father/parent's place of birth Yes Yes Father/parent's date of birth or age at the time of child's birth Yes Yes Evidence required by RCW 70.58A.120 , 70.58A.130 , and WAC 246-490-081 No Yes Date record filed Yes Yes Fee number Yes Yes Signature of applicant No Yes Vital Record Item Certification of Birth and Informational Birth Copy Certification of Delayed Birth and Informational Delayed Birth Copy State file number Yes Yes Date certificate issued Yes Yes First and middle name(s) of subject of the record Yes Yes Last name(s) of subject of the record Yes Yes Date of birth of subject of the record Yes Yes Facility born Yes Yes Place of birth (city, county, state) Yes Yes Time of birth Yes Yes Sex Yes Yes Mother/parent's name prior to first marriage Yes Yes Mother/parent's place of birth Yes Yes Mother/parent's date of birth or age at the time of child's birth Yes Yes Father/parent's current legal name Yes Yes Father/parent's place of birth Yes Yes Father/parent's date of birth or age at the time of child's birth Yes Yes Evidence required by RCW 70.58A.120 , 70.58A.130 , and WAC 246-490-081 No Yes Date record filed Yes Yes Fee number Yes Yes Signature of applicant No Yes (2)(a) For deaths registered starting January 1, 2018, long form certifications of death, short form certifications of death, and informational copies of death will display only the following items: Vital Record Item Long Form Certification of Death Short Form Certification of Death Informational Copy of Death State file number Yes Yes Yes Date certificate issued Yes Yes Yes Fee number Yes Yes Yes Decedent's legal first and middle name(s) Yes Yes Yes Decedent's last name(s) Yes Yes Yes County of death Yes Yes Yes Date of death Yes Yes Yes Hour of death Yes Yes Yes Sex Yes Yes Yes Age Yes Yes Yes Social Security number Yes No No Place of death Yes Yes Yes Facility or address of death Yes Yes Yes City, state, zip Yes Yes Yes Hispanic origin Yes Yes Yes Race Yes Yes Yes Residence street Yes Yes Yes Residence city, state, zip Yes Yes Yes Residence county Yes Yes Yes Is residence inside city limits? Yes Yes Yes Tribal reservation Yes Yes Yes Length of time at residence Yes Yes Yes Birth date Yes Yes Yes Birthplace Yes Yes Yes Father/parent name Yes Yes Yes Mother/parent name Yes Yes Yes Marital status Yes Yes Yes Spouse Yes Yes Yes Method of disposition of remains Yes Yes Yes Place of disposition of remains Yes Yes Yes City, state of disposition of remains Yes Yes Yes Disposition date of remains Yes Yes Yes Occupation Yes Yes Yes Industry Yes Yes Yes Education Yes Yes Yes U.S. Armed Forces Yes Yes Yes Informant name Yes Yes Yes Informant's relationship to decedent Yes Yes Yes Informant's address Yes Yes Yes Funeral facility Yes Yes Yes Funeral facility address Yes Yes Yes Funeral facility city, state, zip Yes Yes Yes Funeral director name Yes Yes Yes Cause of death (A, B, C, and D) Yes No No Other conditions contributing to death Yes No No Date of injury Yes No No Hour of injury Yes No No Injury at work Yes No No Place of injury Yes No No Location of injury Yes No No City, state, zip of injury Yes No No County of injury Yes No No Describe how the injury occurred Yes No No If transportation injury, specify Yes No No Manner of death Yes No No Autopsy Yes No No Were autopsy findings available to complete cause of death? Yes No No Did tobacco use contribute to death? Yes No No Pregnancy status if female Yes No No Certifier name Yes No No Certifier title Yes No No Certifier address Yes No No Certifier city, state, zip Yes No No Date signed by certifier Yes No No Case referred to ME/coroner? Yes No No File number Yes No No Attending physician Yes No No Local deputy registrar Yes Yes Yes Date received by local deputy registrar Yes Yes Yes Vital Record Item Long Form Certification of Death Short Form Certification of Death Informational Copy of Death State file number Yes Yes Yes Date certificate issued Yes Yes Yes Fee number Yes Yes Yes Decedent's legal first and middle name(s) Yes Yes Yes Decedent's last name(s) Yes Yes Yes County of death Yes Yes Yes Date of death Yes Yes Yes Hour of death Yes Yes Yes Sex Yes Yes Yes Age Yes Yes Yes Social Security number Yes No No Place of death Yes Yes Yes Facility or address of death Yes Yes Yes City, state, zip Yes Yes Yes Hispanic origin Yes Yes Yes Race Yes Yes Yes Residence street Yes Yes Yes Residence city, state, zip Yes Yes Yes Residence county Yes Yes Yes Is residence inside city limits? Yes Yes Yes Tribal reservation Yes Yes Yes Length of time at residence Yes Yes Yes Birth date Yes Yes Yes Birthplace Yes Yes Yes Father/parent name Yes Yes Yes Mother/parent name Yes Yes Yes Marital status Yes Yes Yes Spouse Yes Yes Yes Method of disposition of remains Yes Yes Yes Place of disposition of remains Yes Yes Yes City, state of disposition of remains Yes Yes Yes Disposition date of remains Yes Yes Yes Occupation Yes Yes Yes Industry Yes Yes Yes Education Yes Yes Yes U.S. Armed Forces Yes Yes Yes Informant name Yes Yes Yes Informant's relationship to decedent Yes Yes Yes Informant's address Yes Yes Yes Funeral facility Yes Yes Yes Funeral facility address Yes Yes Yes Funeral facility city, state, zip Yes Yes Yes Funeral director name Yes Yes Yes Cause of death (A, B, C, and D) Yes No No Other conditions contributing to death Yes No No Date of injury Yes No No Hour of injury Yes No No Injury at work Yes No No Place of injury Yes No No Location of injury Yes No No City, state, zip of injury Yes No No County of injury Yes No No Describe how the injury occurred Yes No No If transportation injury, specify Yes No No Manner of death Yes No No Autopsy Yes No No Were autopsy findings available to complete cause of death? Yes No No Did tobacco use contribute to death? Yes No No Pregnancy status if female Yes No No Certifier name Yes No No Certifier title Yes No No Certifier address Yes No No Certifier city, state, zip Yes No No Date signed by certifier Yes No No Case referred to ME/coroner? Yes No No File number Yes No No Attending physician Yes No No Local deputy registrar Yes Yes Yes Date received by local deputy registrar Yes Yes Yes (b) For deaths registered before January 1, 2018, long form certifications of death will contain only the vital record items as indicated for long form certification in (a) of this subsection if such vital record items are available or were collected at the time of death registration. (c) For deaths registered before January 1, 2018, informational copies of death will contain only the vital record items as indicated for informational death copy in (a) of this subsection if such vital record items are available or were collected at the time of death registration. (d) The short form certification of death is not available for deaths registered before January 1, 2018. (3)(a) Certification of fetal death and certification of birth resulting in stillbirth will display only the following items: Vital Record Item Certification of Fetal Death Certification of Birth Resulting in Stillbirth State file number Yes Yes Date certificate issued Yes Yes First and middle name(s) of fetus Yes Yes Last name(s) of fetus Yes Yes Sex Yes Yes Date and time of delivery Yes Yes Place of delivery (city, county, state) Yes Yes Name of facility Yes Yes Mother/parent's name prior to first marriage Yes Yes Mother/parent's place of birth Yes Yes Mother/parent's date of birth or age at the time of the delivery Yes Yes Father/parent's current legal name Yes Yes Father/parent's place of birth Yes Yes Father/parent's date of birth or age at the time of the delivery Yes Yes Name and title of person completing cause of death Yes No Date signed by person completing cause of death Yes No Name and title of person delivering the fetus Yes No Method of disposition Yes Date of disposition Yes No Place of disposition Yes No Disposition location – City/town, and state Yes No Funeral facility name Yes No Funeral facility address Yes No Funeral director name Yes No Initiating cause/condition Yes No Other significant causes or conditions Yes No Estimated time of fetal death Yes No Was an autopsy performed? Yes No Was a histological placental examination performed? Yes No Local deputy registrar Yes No Data record filed Yes Yes Fee number Yes Yes Vital Record Item Certification of Fetal Death Certification of Birth Resulting in Stillbirth State file number Yes Yes Date certificate issued Yes Yes First and middle name(s) of fetus Yes Yes Last name(s) of fetus Yes Yes Sex Yes Yes Date and time of delivery Yes Yes Place of delivery (city, county, state) Yes Yes Name of facility Yes Yes Mother/parent's name prior to first marriage Yes Yes Mother/parent's place of birth Yes Yes Mother/parent's date of birth or age at the time of the delivery Yes Yes Father/parent's current legal name Yes Yes Father/parent's place of birth Yes Yes Father/parent's date of birth or age at the time of the delivery Yes Yes Name and title of person completing cause of death Yes No Date signed by person completing cause of death Yes No Name and title of person delivering the fetus Yes No Method of disposition Yes Date of disposition Yes No Place of disposition Yes No Disposition location – City/town, and state Yes No Funeral facility name Yes No Funeral facility address Yes No Funeral director name Yes No Initiating cause/condition Yes No Other significant causes or conditions Yes No Estimated time of fetal death Yes No Was an autopsy performed? Yes No Was a histological placental examination performed? Yes No Local deputy registrar Yes No Data record filed Yes Yes Fee number Yes Yes (b) For fetal deaths registered before October 1, 2022, certifications of fetal death or certification of birth resulting in stillbirth will contain only the vital record items as indicated in (a) of this subsection if such vital record items are available or were collected at the time of fetal death registration. (c) The certification of birth resulting in stillbirth is not proof of a live birth and is not an identity document.