13-01-004  

  • WSR 13-01-004

    PERMANENT RULES

    DEPARTMENT OF HEALTH


    [ Filed December 6, 2012, 5:36 a.m. , effective December 6, 2012 ]


         Effective Date of Rule: December 6, 2012.

         Other Findings Required by Other Provisions of Law as Precondition to Adoption or Effectiveness of Rule: Such action is necessary to comply with chapter 3, Laws of 2012 (ESSB 6239).

         Purpose: WAC 246-491-149, the rule provides gender-neutral terms for spouses on marriage and divorce certificates and adds sex as an item on the marriage certificate. The rule change is in response to the same-sex marriage law, approved by voters as Referendum 74. Same-sex couples who marry may expect their marriage and divorce certificates to use gender-neutral language. The public may have an interest in knowing how many same-sex marriages occur.

         Citation of Existing Rules Affected by this Order: Amending WAC 246-491-149.

         Statutory Authority for Adoption: RCW 43.70.150.

          Adopted under notice filed as WSR 12-21-117 on October 23, 2012.

         Changes Other than Editing from Proposed to Adopted Version: The adopted version allows people to choose among the terms bride, groom and spouse on the marriage certificate under the headings of Person A and Person B, which differentiate one person's information from the other's [information]. The adopted version omits a proposed item on last name after marriage and clarifies the name associated with each signature in the section on Social Security numbers.

         Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 1, Repealed 0.

         Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

         Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 1, Repealed 0.

         Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.

         Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.

         Date Adopted: December 6, 2012.

    Mary C. Selecky

    Secretary

    OTS-5081.2


    AMENDATORY SECTION(Amending WSR 09-11-111, filed 5/19/09, effective 6/19/09)

    WAC 246-491-149   Information collected on the legal or public section of certificates; modifications to the United States standard certificates and report forms.   (1) Effective January 1, 2003, the department shall use the 2003 revisions of the United States standard forms for live birth and fetal death.

         (2) Effective January 1, 2004, the department shall use the 2003 standard form for death.

         (3) Effective January 1, 1992, the department shall use the 1988 revisions of the United States standard forms for marriage and certificate of divorce, dissolution of marriage or annulment.

         (4) These forms are developed by the United States Department of Health and Human Services, National Center for Health Statistics. Copies of these forms may be obtained by contacting the department's center for vital statistics.

         (5) With the exception of the confidential section, the department may modify any part of these forms.

         (a) Table 3 identifies the modifications to the United States standard form for live birth.

         (b) Table 4 identifies the modifications to the United States standard form for fetal death.

         (c) Table 5 identifies the modifications to the United States standard form for death.

         (d) Table 6 identifies modifications to the United States standard form for marriage.

         (e) Table 7 identifies modifications to the United States standard form for certificate of divorce, dissolution of marriage, or annulment.

         (6) Table 8 lists items to be collected on the certificate of dissolution of Washington state domestic partnership. This is a Washington state form not addressed in the United States standard forms.


    U.S. STANDARD CERTIFICATE OF LIVE BIRTH
    Table 3:

    Legal or Public Birth Certificate Items

    Item Number Item Name Difference from U.S. Standard, if any
    1 Child's name
    2 Child's date of birth
    3 Time of birth
    4 Type of birthplace Add "En route," Add "Planned birthplace if different"
    5 Child's sex
    6 Name of facility
    7 City, town or location of birth
    8 County of birth
    9 Mother's name before first marriage
    10 Mother's date of birth
    11 Mother's birthplace
    12 Mother's Social Security number
    13 Mother's current legal last name
    14 Social Security number requested for child?
    16a Mother's residence - Number, street, and Apt. No.
    16b Mother's residence - City or town
    16c Mother's residence - County
    16d Tribal reservation name (if applicable) Added
    16e Mother's residence - State or foreign country
    16f Mother's residence - Zip code + 4
    16g Mother's residence - Inside city limits?
    17 Telephone number Added
    18 How long at current residence? Added
    19 Mother's mailing address, if different
    25 Father's current legal name
    26 Father's date of birth
    27 Father's birthplace
    28 Father's Social Security number
    66 Certifier name and title Delete check boxes
    67 Date certified
    68 Attendant name and title Delete check boxes
    69 NPI of person delivering the baby
    -- Date filed by registrar Deleted

    U.S. STANDARD REPORT OF FETAL DEATH
    Table 4:

    Legal or Public Fetal Death Certificate Items

    Item Number Item Name Difference from U.S. Standard, if any
    1 Name of fetus
    2 Sex
    3 Date of delivery
    4 Time of delivery
    5 Type of birthplace Add "En route," Add "Planned birthplace if different"
    6 Name of facility
    7 Facility ID (NPI)
    8 City, town or location of birth
    9 Zip code of delivery
    10 County of birth
    11 Mother's name before first marriage
    12 Mother's date of birth
    13 Mother's current legal last name
    14 Mother's birthplace
    15a Mother's residence - Number, street, and Apt. No.
    15b Mother's residence - City or town
    15c Mother's residence - County
    15d Tribal reservation name (if applicable) Added
    15e Mother's residence - State or foreign country
    15f Mother's residence - Zip code + 4
    15g Mother's residence - Inside city limits?
    16 How long at current residence? Added
    17 Father's current legal name
    18 Father's date of birth
    19 Father's birthplace
    20 Name and title of person completing the report
    21 Date report completed
    22 Attendant name and title Delete check boxes
    23 NPI of person delivering the baby
    24 Method of disposition
    25 Date of disposition
    26 Place of disposition Added
    27 Location of disposition - City/town and state Added
    28 Name and complete address of funeral facility Added
    29 Funeral director signature Added
    30 Initiating cause/condition (cause of death)
    31 Other significant causes or conditions
    32 Estimated time of fetal death
    33 Was an autopsy performed?
    34 Was a histological placental examination performed?
    35 Were autopsy or histological placental examination results used in determining the cause of death?
    36 Registrar signature Added
    37 Date received

    U.S. STANDARD CERTIFICATE OF DEATH
    Table 5:

    Death Certificate Items

    Item Number Item Name Difference from U.S. Standard, if any
    1 Legal name (include a.k.a.'s if any)
    2 Death date
    3 Sex
    4a Age - Years
    4b Age - Under 1 year
    4c Age - Under 1 day
    5 Social Security number
    6 County of death
    7 Birth date
    8a Birth place - City, town or county
    8b Birth place - State or foreign country
    9 Decedent's education Add "Specify": next to box for "8th Grade or less"
    10 Decedent's Hispanic origin
    11 Decedent's race
    12 Was decedent ever in U.S. Armed Forces?
    13a Residence - Number and street
    13b Residence - City or town
    13c Residence - County
    13d Tribal reservation name (if applicable) Added
    13e Residence - State or foreign country
    13f Residence - Zip code
    13g Inside city limits?
    14 Estimated length of time at residence Added
    15 Marital status at time of death
    16 Surviving spouse's name
    17 Occupation
    18 Kind of business/industry
    19 Father's name
    20 Mother's name before first marriage
    21 Informant - Name
    22 Informant - Relationship to decedent
    23 Informant - Address
    24 Place of death
    25 Facility name (if not a facility, give number and street)
    26a City, town, or location of death
    26b State of death
    27 Zip code of death
    28 Method of disposition
    29 Place of disposition (name of cemetery, crematory, other place)
    30 Disposition - City/town, and state
    31 Name and complete address of funeral facility
    32 Date of disposition Added
    33 Funeral director signature
    34 Causes of death and intervals between onset and death
    35 Other significant conditions contributing to death
    36 Autopsy?
    37 Were autopsy findings available to complete the cause of death?
    38 Manner of death
    39 Pregnancy status
    40 Did tobacco use contribute to death?
    41 Date of injury
    42 Hour of injury
    43 Place of injury
    44 Injury at work?
    45 Injury location - Street, city, county, state, zip County Added
    46 Describe how injury occurred
    47 Transport injury type
    48a Certifying physician signature
    48b Medical examiner/coroner signature
    49 Name and address of certifier
    50 Hour of death
    51 Name and title of attending physician if other than certifier Added
    52 Date certified
    53 Title of certifier
    54 License number of certifier
    55 ME/coroner file number Added
    56 Was case referred to medical examiner?
    57 County registrar signature Added
    58 County date received Added
    59 Record amendment Added
    -- License number of funeral director Deleted
    -- Date pronounced dead Deleted
    -- Time pronounced dead Deleted
    -- Signature of person pronouncing death Deleted
    -- License number of person pronouncing death Deleted
    -- Date person pronouncing death signed Deleted

    U.S. STANDARD LICENSE AND CERTIFICATE OF MARRIAGE
    Table 6:

    Certificate of Marriage

    Item Number Item Name Difference from U.S. Standard, if any
    ((-- Certificate name Changed name of form to "Certificate of Marriage”
    -- County of license
    -- Date valid
    -- Not valid after (date)
    1 Date of marriage
    2 County of ceremony
    3 Type of ceremony Added
    4 Date signed (by officiant) Added
    5 Officiant's name
    6 Officiant's signature
    7 Officiant's address
    8 Groom's name
    9 Groom's address (street)
    10 Groom's date of birth
    11 Groom's place of birth (state or country)
    12 Groom's address (city)
    13 Groom's address (inside city limits) Added
    14 Groom's address (county)
    15 Groom's address (state)
    16 Groom's father - Name
    17 Groom's father - Place of birth
    18 Groom's mother - Maiden name
    19 Groom's mother - Place of birth
    20 Groom's signature
    21 Date signed (by groom)
    22 Bride's name
    23 Bride's maiden last name
    24 Bride's residence - (Street)
    25 Bride's date of birth
    26 Bride's place of birth (state or country)
    27 Bride's residence (city)
    28 Bride's residence (inside city limits) Added
    29 Bride's residence (county)
    30 Bride's residence (state)
    31 Bride's father - Name
    32 Bride's father - Place of birth
    33 Bride's mother - Maiden name
    34 Bride's mother - Place of birth
    35 Bride's signature
    36 Date signed (by bride)
    37 Witness #1 signature
    38 Witness #2 signature
    39 County auditor signature
    40 Date received (by county auditor)
    Reverse side Groom's Social Security number
    Reverse side Bride's Social Security number
    Groom's age last birthday Deleted
    Bride's age last birthday Deleted
    License to marry section Deleted
    Expiration date of license Deleted
    Title of issuing official Deleted
    Confidential information Deleted))
    Certificate name Modified
    1 County of license Added
    2 Date valid
    3 Not valid after (date)
    4 County auditor signature
    5 Date received (by county auditor)
    6a Person A - Bride/groom/spouse Added
    6b Legal name before marriage Modified
    6c Birth name, if different Added
    6d Sex - Male/female Added
    6e Current residence (street, city/town)
    6f County of residence
    6g State of residence
    6h Date of birth
    6i Birth state (if not USA, provide country)
    6j Mother/parent birth name Modified
    6k Father/parent birth name Modified
    6l Mother/parent birth state (or country) Modified
    6m Father/parent birth state (or country) Modified
    7a Person B - Bride/groom/spouse Added
    7b Legal name before marriage
    7c Birth name, if different Modified
    7d Sex - Male/female Added
    7e Current residence (street, city/town)
    7f County of residence
    7g State of residence
    7h Date of birth
    7i Birth state (if not USA, provide country)
    7j Mother/parent birth name Modified
    7k Father/parent birth name Modified
    7l Mother/parent birth state (or country) Modified
    7m Father/parent birth state (or country) Modified
    8 Date of marriage
    9 County of ceremony
    10 Type of ceremony Added
    11 Date signed (by officiant) Added
    12 Officiant's address
    13 Officiant's daytime phone Added
    14 Officiant's name
    15 Officiant's signature
    16 Witness signature
    17 Witness signature
    18 Person A signature Modified
    19 Date signed (by person A) Added
    20 Person B signature Modified
    21

    Date signed (by person B) Added
    22 Person A - Social Security number Added
    23 Person A - Name Added
    24 Person B - Social Security number Added
    25 Person B - Name Added
    26 Person A signature - Declaration in absence of a Social Security number Added
    27 Person A date - Declaration in absence of a Social Security number Added
    28 Person B signature - Declaration in absence of a Social Security number Added
    29 Person B date - Declaration in absence of a Social Security number Added
    (Groom's) age last birthday Deleted
    (Bride's) age last birthday Deleted
    Signature of (license) issuing official Deleted
    Title of (license) issuing official Deleted
    Where married - City, town or location Deleted
    Title (of officiant) Deleted
    Confidential information Deleted
    U.S. STANDARD CERTIFICATE OF DIVORCE, DISSOLUTION OF MARRIAGE, OR ANNULMENT
    TABLE 7:

    Certification of Dissolution, Declaration of Invalidity of Marriage, or Legal Separation

    Item Number Item Name Difference from U.S. Standard, if any
    ((Certificate name Changed form name to certificate of dissolution, declaration of invalidity of marriage or legal separation
    Court file number
    1 Type of decree Added check boxes
    2 Date of filing
    3 County where decree filed
    4 Signature of superior court clerk
    5 Husband's name
    6 Husband's date of birth
    7 Husband's place of birth
    8 Husband's residence - street
    9 Husband's residence - city
    10 Husband's residence - Inside city limits Added
    11 Husband's residence - County
    12 Husband's residence - State
    13 Wife's name
    14 Wife's maiden name
    15 Wife's date of birth
    16 Wife's place of birth
    17 Wife's residence - Street
    18 Wife's residence - City
    19 Wife's residence - Inside city limits Added
    20 Wife's residence - County
    21 Wife's residence - State
    22 Place of marriage - County
    23 Place of marriage - State
    24 Date of marriage
    25 Number of children of this marriage Name change
    26 Petitioner Delete check boxes
    27 Name of petitioner's attorney/pro se
    28 Petitioner's address
    29 Husband's Social Security number
    30 Wife's Social Security number
    Date couple last resided in same household Delete
    Number of children under 18 whose physical custody was awarded to Delete
    Title of court Delete
    Title of certifying official Delete
    Date signed Delete
    Confidential information Delete))
    Certificate name Modified
    1 Court file number Added
    2

    Type of decree
    3 Date of decree
    4 County where decree filed
    5 Signature of superior court clerk
    6a Spouse A - Name Added
    6b Birth name, if different Added
    6c Date of birth
    6d Place of birth (state or country)
    6e Residence - Street Added
    6f Residence - City
    6g Residence - County
    6h Residence - State
    7a Spouse B - Name Added
    7b Birth name, if different Modify
    7c Date of birth
    7d Place of birth (state or country)
    7e Residence - Street Added
    7f Residence - City
    7g Residence - County
    7h Residence - State
    8 Place of marriage -County
    9 Place of marriage - State
    10 Date of marriage
    11 Number of children born alive of this marriage Added
    12 Petitioner
    13 Name of petitioner's attorney or pro se
    14 Petitioner's attorney's address
    15 Spouse A Social Security number Added
    16 Spouse B Social Security number Added
    Date (decree) recorded Deleted
    Number of children under 18 whose physical custody was awarded to (husband, wife, joint, other) Deleted
    Number of children under 18 in household Deleted
    Title of court Deleted
    Title of certifying official Deleted
    Date (certifying official) signed Deleted
    Date couple last resided in same household Deleted
    Confidential items Deleted

    TABLE 8:

    Certification of Dissolution of Washington State Domestic Partnership

    Item Number Item Name
    Certificate name
    Court file number
    1 Type of decree
    2 Date of decree
    3 County where decree filed
    4 Signature of superior court clerk
    5a First partner's name
    5b First partner's name at birth
    6 First partner's date of birth
    7 First partner's place of birth
    8 First partner's residence - Street
    9 First partner's residence - City
    10 First partner's residence - Inside city limits
    11 First partner's residence - County
    12 First partner's residence - State
    13a Second partner's name
    13b Second partner's name at birth
    14 Second partner's date of birth
    15 Second partner's place of birth
    16 Second partner's residence - Street
    17 Second partner's residence - City
    18 Second partner's residence - Inside city limits
    19 Second partner's residence - County
    20 Second partner's residence - State
    21 Date of this partnership
    22 Domestic partnership certificate number
    23 Petitioner
    24 Name of petitioner's attorney/pro se
    25 Petitioner's address

    [Statutory Authority: RCW 26.09.150. 09-11-111, § 246-491-149, filed 5/19/09, effective 6/19/09. Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. 02-20-092, § 246-491-149, filed 10/1/02, effective 11/1/02. Statutory Authority: RCW 43.70.150. 91-23-026 (Order 211), § 246-491-149, filed 11/12/91, effective 12/13/91. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-491-149, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20A.620. 88-19-034 (Order 2696), § 248-124-160, filed 9/12/88.]

Document Information

Effective Date:
12/6/2012
Rules:
246-491-149