Domestic Partnership Declaration Page 3
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3Declaration of State Registered Domestic Partnership
INSTRUCTIONS -
Complete all sections. USE DARK INK ONLY
Partner 1
Complete the name, place of birth, and date of birth portion of the Declaration of State Registered Domestic
Partnership.
Partner 2
Complete the name, place of birth, and date of birth portion of the Declaration of State Registered Domestic
Partnership.
Address
Complete the street address portion of the form. You may also provide an additional mailing or postal address
if different than your street address.
Declaration
Both partners must sign this section. A notary is required for each partner’s signature. The form provides
space for a separate notarization allowing partners to sign at different times or places.
Additional Information
At the time of filing, the Corporations Division will provide each partner with one original Certificate of State
Registered Domestic Partnership and one wallet card showing registration of the State registered Domestic
Partnership. After the date of filing, additional certificates are available from the Corporations Division for a fee
of $5.00 each. Replacement wallet cards are available for a fee of $10.00 each.
Fees: The filing fee for Declaration of State Registered Domestic Partnership is $50.00. Make the checks or
money orders payable to “Secretary of State.” If expedited service is requested then include an additional
$50.00 and write “EXPEDITE” on the outside of the envelope.
All payments must be received in US Dollars. All fees are non-refundable.
Mail completed forms and payment to:
Secretary of State
Corporation Division
801 Capitol Way S
PO Box 40234
Olympia WA 98504-0234
If you have questions, need assistance, or would like to provide feedback please visit the Corporations Division
website at
or call 360-725-0377.
Domestic Partnership - Declaration
Washington Secretary of State
Revised 07/14
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