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Get WA DOH 651-001 2014

The name appearing on your official certificate of birth or, if your name has changed since birth, on an official marriage certificate or an order by a court. The court must have legal authority to change your name. We may ask you to prove your legal name. If you use any name other than your legal name on this form, your application may be denied. Birth date: Provide the month, day, and year you were born. Birth place: Provide the city, state, and country where you were born. Address: .

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