Public Records Request Form

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
What type of record(s) are you requesting?*
Describe the records you are requesting and provide any additional information to help locate the records, such as author, recipient, title, and pertinent dates.
I would like to:*
- Inspect the Records
- Receive electronic copies of the records (if available in electronic form)
- Pick up hard copies of the records at the District headquarters (1164 Race Road, Coupeville, WA)
- Receive hard copies via mail
If my request is for a list of individuals, I certify under penalty of perjury under the laws of the state of Washington that the information obtained through this request will not be used for commercial purposes.*
- Yes
- No

CENTRAL WHIDBEY ISLAND