Domestic Partnership Declaration Page 2
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Declaration of State Registered Domestic Partnership
Important information:
Registration of a domestic partnership may affect property and inheritance rights and is not a substitute for a
will, deed, or partnership agreement. Any rights conferred by this registration may be superseded by a will,
deed, or other instrument signed by either party to this domestic partnership registration.
Records of State Registered Domestic Partnerships are public and will be disclosed on request. Information
about State Registered Domestic Partnerships will be shared with the Washington State Department of Health.
Partner 1 Name (Print)
Partner 2 Name (Print)
We declare that we meet the requirements for registration of a domestic partnership pursuant to Chapter
26.60 RCW, and that:
•
We share a common residence;
•
We are both at least eighteen (18) years of age;
•
Neither partner is married to anyone else, or in a state registered domestic partnership with any other
person;
•
We are both capable of consenting to this domestic partnership;
•
We are not of any relation to each other nearer than second cousin and neither partner is a sibling,
child, grandchild, aunt, uncle, niece or nephew to the other;
•
One of us is at least 62 years of age
These representations are true and correct, and contain no material omissions of fact to the best of our
knowledge and belief.
X
X
Partner 1 (Signature)
Partner 2 (Signature)
State of Washington
State of Washington
County of
County of
Signed and affirmed before me on
Signed and affirmed before me on
By Partner 1
By Partner 2
(print name)
(print name)
Notary Public Signature
Notary Public Signature
My Commission Expires:
My Commission Expires:
Notary seal
Notary seal
Domestic Partnership - Declaration
Washington Secretary of State
Revised 07/14
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