Request for Public Records You are here: >> Forms & Documents >> Request for Public Records >> Please fill out the form below or download and print a copy (pdf) to submit to our office. Date of Request* MM slash DD slash YYYY Time of Request* : Hours Minutes AM PM AM/PM Requestor Name* First Last Email Address* Business Name (if applicable) Requestor Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip Code Phone*When requesting records, please be as specific as possible in the types of documents you’re requesting (e.g. reports, emails, letters, etc.). Please provide a timeline, clearly spelled names, addresses, and identification numbers. Providing specific information will allow us to process your request more efficiently.Description of Public Records Requested (please be specific)*If you are requesting to inspect records at the agency’s location, please allow a minimum of five [5] business days from the date of request to ensure adequate time for the agency to provide the records requested. Date of Inspection MM slash DD slash YYYY Time of Inspection : Hours Minutes AM PM AM/PM I understand there may be a cost for production of these records and I may be charged a fee according to PLIA’s Fee Schedule. (RCW 42.56.120[2][b] & [c], [3], [4]; RCW 42.56.13) I certify that any records listing individuals will NOT be used for commercial purposes. Signature Reset signature Signature locked. Reset to sign again Date MM slash DD slash YYYY CAPTCHA
