What edition of DOH 422-186 does this guide cover?
July 2025.
Document Guides
Washington DOH 422-186: Authorized Representative Vital Records Form
DOH 422-186 lets a qualified applicant authorize a representative for birth, death, or fetal death certificates—both parties sign before a notary, one-time use within 60 days, and POA is a separate pathway.
iRemoteNotary Editorial Team
Published and reviewed by iRemoteNotary
Last reviewed September 20, 2026
Quick Answer
Who must sign Washington DOH 422-186 before a notary?
Both the qualified applicant and the authorized representative must sign in the presence of a notary. Two different notaries may complete the two notarial blocks on one form; Washington accepts one complete form, not two separate notarized forms.
The form covers authorizing a representative to request a birth, death, or fetal death certificate. Submit it within 60 days of notarization with the certificate application. Power of attorney is an alternate pathway—not the same as this form. Confirm remote online notarization acceptance before booking.
DOH 422-186 at a glance
| Item | Verified detail |
|---|---|
| Form | DOH 422-186 — Authorized Representative Form |
| Edition | July 2025 |
| Record types | Birth, death, and fetal death certificates |
| Signatures | Qualified applicant AND authorized representative — each before a notary |
| Submission window | Within 60 days of notarization; one-time use |
| RON status | Recipient confirmation required — no express DOH RON acceptance statement reviewed for this form |
Washington's Authorized Representative Form (DOH 422-186, July 2025) is a legal document that lets a qualified applicant authorize another person to request a birth, death, or fetal death certificate on the applicant's behalf.
iRemoteNotary is a national and international online-notary organization. Remote online notarization is performed under the law of the online notary's commissioning state. For other vital-records packets, start at the Vital Records Notary Center.
Two Signatures, Each Before a Notary
DOH instructions are explicit: the qualified applicant must fill out the fields and sign in the presence of a notary, and the authorized representative must also sign in the presence of a notary. The notary or notaries must sign, print their name, stamp, and date.
Two different notaries may notarize the form—for example when the parties live in different states—but Washington will only accept one complete form, not two separate notarized forms pieced together as substitutes.
| Signer | Requirement | Common mistake |
|---|---|---|
| Qualified applicant | Sign in presence of a notary on the form | Leaving the applicant block blank or unsigned |
| Authorized representative | Sign in presence of a notary on the same form | Assuming one notarized signature covers both parties |
| Two notaries | Allowed on one complete form | Submitting two separate half-forms instead of one complete DOH 422-186 |
60-Day Window and One-Time Use
The Authorized Representative Form is for one-time use only and must be used within sixty (60) days of the form being notarized. After notarization, the authorized representative submits the form with a completed application for the certificate identified on the form—online, phone, mail, or in person as Washington currently allows.
The form serves as eligibility documentation for the representative pathway; identity documents and applicable fees still apply under Washington's application rules.
- Download DOH 422-186 July 2025
- Qualified applicant completes fields and signs before a notary
- Authorized representative signs before a notary (same form)
- Submit within 60 days with the matching certificate application
- Treat as one-time use only
- Confirm RON acceptance before booking remote online notarization
Ready to notarize DOH 422-186?
If both parties will complete the July 2025 form before a notary (or two notaries on one form), understand the 60-day submission window, and will confirm recipient acceptance of remote online notarization, start a secure session with a commissioned U.S. online notary.
Power of Attorney Is a Different Pathway
Washington's form instructions define an authorized representative as a person identified in a notarized form signed by a qualified applicant, or an agent identified in a power of attorney. Those are alternate pathways—not interchangeable labels for the same packet.
If you are using a POA instead of DOH 422-186, follow Washington's current POA and application instructions. Do not assume completing 422-186 is required when a valid POA pathway applies, and do not assume a POA replaces 422-186 when you intended to use this form.
Important Limits
Notarization does not make someone a qualified applicant if they are not. It does not issue the certified vital record, and it is not an apostille.
iRemoteNotary does not issue vital records, determine eligibility, issue apostilles, or guarantee acceptance. See online notarized document and apostille when foreign authentication is separately required.
Frequently asked questions
Must both parties sign before a notary?
Yes. The qualified applicant and the authorized representative each sign in the presence of a notary on the form.
Can two different notaries be used?
Yes, on one complete form. Do not submit two separate notarized forms in place of one complete DOH 422-186.
How long after notarization can the form be used?
Within 60 days of notarization, and for one-time use only.
Does this form cover marriage certificates?
The July 2025 instructions frame this authorized-representative form for birth, death, and fetal death certificates. Confirm current DOH instructions for marriage or divorce if those are your records.
Is a power of attorney the same as DOH 422-186?
No. POA is described as an alternate way to identify an authorized representative. Follow the pathway you actually intend to use.
Can I use remote online notarization for DOH 422-186?
Only if Washington Department of Health accepts remotely notarized signatures for this form and your submission channel. Confirm before booking. Recipient confirmation is required.
Related pages
Sources and Official References
The following primary sources support the legal and procedural information in this guide. Requirements can change, so confirm current rules with the receiving organization before relying on a notarized document.
Authorized Representative Form (DOH 422-186, July 2025)(opens in a new tab)
Washington State Department of Health
Accessed September 20, 2026
Birth, Death, Marriage and Divorce(opens in a new tab)
Washington State Department of Health
Accessed September 20, 2026
DOH 422-186 ready for notarization?
Use July 2025 DOH 422-186, complete both notarial signature blocks on one form, submit within 60 days, and confirm remote online notarization acceptance with Washington before booking a commissioned U.S. online notary.