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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Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 1, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 1, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.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 nameChanged name of form to "Certificate of Marriage”--County of license--Date valid--Not valid after (date)1Date of marriage2County of ceremony3Type of ceremonyAdded4Date signed (by officiant)Added5Officiant's name6Officiant's signature7Officiant's address8Groom's name9Groom's address (street)10Groom's date of birth11Groom's place of birth (state or country)12Groom's address (city)13Groom's address (inside city limits)Added14Groom's address (county)15Groom's address (state)16Groom's father - Name17Groom's father - Place of birth18Groom's mother - Maiden name19Groom's mother - Place of birth20Groom's signature21Date signed (by groom)22Bride's name23Bride's maiden last name24Bride's residence - (Street)25Bride's date of birth26Bride's place of birth (state or country)27Bride's residence (city)28Bride's residence (inside city limits)Added29Bride's residence (county)30Bride's residence (state)31Bride's father - Name32Bride's father - Place of birth33Bride's mother - Maiden name34Bride's mother - Place of birth35Bride's signature36Date signed (by bride)37Witness #1 signature38Witness #2 signature39County auditor signature40Date received (by county auditor)Reverse sideGroom's Social Security numberReverse sideBride's Social Security numberGroom's age last birthdayDeletedBride's age last birthdayDeletedLicense to marry sectionDeletedExpiration date of licenseDeletedTitle of issuing officialDeletedConfidential informationDeleted))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 nameChanged form name to certificate of dissolution, declaration of invalidity of marriage or legal separationCourt file number1Type of decreeAdded check boxes2Date of filing3County where decree filed4Signature of superior court clerk5Husband's name6Husband's date of birth7Husband's place of birth8Husband's residence - street9Husband's residence - city10Husband's residence - Inside city limitsAdded11Husband's residence - County12Husband's residence - State13Wife's name14Wife's maiden name15Wife's date of birth16Wife's place of birth17Wife's residence - Street18Wife's residence - City19Wife's residence - Inside city limitsAdded20Wife's residence - County21Wife's residence - State22Place of marriage - County23Place of marriage - State24Date of marriage25Number of children of this marriageName change26PetitionerDelete check boxes27Name of petitioner's attorney/pro se28Petitioner's address29Husband's Social Security number30Wife's Social Security numberDate couple last resided in same householdDeleteNumber of children under 18 whose physical custody was awarded toDeleteTitle of courtDeleteTitle of certifying officialDeleteDate signedDeleteConfidential informationDelete))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