For certified copies of all Washington State births recorded since 1907,
and Seattle and King County births from all years recorded.
Pursuant to the Revised Code of Washington 70.58.107, if we cannot fill your order because there is no matching record or because you cannot provide the
required information, we are required to charge you an $8 search fee instead of the $20 per certificate fee. In that case, we will provide a partial refund to you.
However, if your order is for a newborn, we will hold it until the hospital has completed the birth registration and fill your order at that time.
CITY STATE ZIP CODE COUNTRY (IF NOT USA)
YOUR RELATIONSHIP TO THE PERSON ON THE CERTIFICATE
CHECK BOX IF THE FATHER NOT LISTED ON THE CERTIFICATE
Washington State Birth Certificate Order
REQUIRED INFORMATION FOR RECORD RELEASE PLEASE WRITE
NONE
WHEN THERE IS NO MIDDLE NAME
FIRST NAME(S)
NAME
ON RECORD
FIRST NAME(S)
MOTHER or
PARENT 1
LAST NAME(S) PRIOR TO MARRIAGE
FIRST NAME(S)
FATHER or
PARENT 2
ORDER BY MAIL ( WITH CHECK OR MONEY ORDER)
MAIL FORM WITH PAYMENT TO: Vital Statistics
Mailbox 359784
325 Ninth Ave
(Payable to Vital Statistics) Seattle, WA 98104-2499
BRING THIS FORM TO: King County Vital Statistics
Harborview Medical Center
Ninth & Jefferson Building
908 Jefferson Street, 2
nd
Floor
Seattle, WA 98104
Number of certificate copies:
Number of certified copies:
NO OTHER FEES WHEN ORDERING IN PERSON
Please note: Refunds not issued for less than $5.00
ORDER BY MAIL (USING DEBIT OR CREDIT CARD)
(or order online at www.kingcounty.gov/vitalstats)
Number of certificate
copies:
Name on card and billing address is:
same as applicant same as shipping or as below
Name on Card Billing Address
Kin
g Coun
ty Vital S
tatistics
www.kingcounty.gov/vitalstats
