Fillable CITY OF COSMOPOLIS PUBLIC RECORDS REQUEST (City of Cosmopolis)

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CITY OF COSMOPOLIS PUBLIC RECORDS REQUEST (City of Cosmopolis)

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The CITY OF COSMOPOLIS PUBLIC RECORDS REQUEST (City of Cosmopolis) form is 1 page long and contains:

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  • 3 check-boxes
  • 25 other fields

Country of origin: US
File type: PDF

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PUBLIC RECORDS REQUEST
Requester’sName__
________________________________________________________________________
MailingAddress____________________________________________________________________________
Phone____________________ Email______________________________
Describetherecordsyouarerequestingandprovideanya
dditionalinformationtohelplocatetherecords,
suchasauthor,recipient,title,andpertinentdates.Attachadditionalpagesifnecessary.
__________________________________
_______________________________________________________
__________________________________
_______________________________________________________
__________________________________
_______________________________________________________
Receivehardcopiesviamailorpickup(circleone)
Inspecttherecords
Receiveelectroniccopiesviaemailorother
(specify:______________________
__)
FeesarechargedasallowedbyRCW42.56
HardCopies$.15/page
Electronic$.10/scannedpage
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.
___________________________________
SignatureandDate
Date Initials Notes FORUSEBYPUBLICRECORDS
OFFICER
DateReceived __________ ______ _________________________________________________________________
Five‐DayNoticeSent __________ ______ _________________________________________________________________
FirstInstallment __________ ______ _________________________________________________________________
CompletingRequest __________ ______ _________________________________________________________________
OtherInstallments __________ ______ _________________________________________________________________
ResponseCompleted __________ ______ _________________________________________________________________
CITY OF COSMOPOLIS
1300 First St
PO Box 2007
Cosmopolis, WA 98537
(360) 532-9230
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CITY OF COSMOPOLIS PUBLIC RECORDS REQUEST (City of Cosmopolis)

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Completed 21 January 2021

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