Name*

Address*

Date:*

Telephone*

Fax No.

Email Address

Please describe the specific records you are requesting and any additional information that will help us locate said records (dates, names, etc.)

Documentation requested:

*

Request Format:
*

Email Delivery Inspection

Copying

Inspection and copying of identifiable City records or a response to the status of the request shall be provided within 5 business days, per RCW 42.56. Should the requested documentation be deemed exempt from disclosure, you will be notified.

Copy charges are per RCW 42.56 and City of Blaine Fee Schedule.

By submitting this request, I agree that the information that I am requesting will not be used for commercial purposes.

I have read the requirements*

I agree

I disagree