Kittitas County
Request for Public Records
Name of person making request:
State: Zip:
I wish to: ____ Inspect records
____ Receive a copy of records
Request made: ____ in Person ____ by phone ____ by fax ____ by email ____ by mail
To assist us in answering your request accurately and promptly, please identify the records you wish to
by referring to a title, name, date of incident, identification number and/or description. If
copies are needed, please indicate which file(s) you would like copied. A fee may be charged for
copies that is based upon the delivery format requested. Please refer to the Fee Schedule outlined in
Kittitas County Code, Chapter 2.55
Please fill in and sign your name below if applicable:
I,___________________________ affirm under penalty of perjury that my request is not for commercial
purposes. This is only required if the request includes a list of individuals. I understand the use of public
records containing lists of individuals for a commercial purpose violates Washington State law and the
privacy of the individuals. “Commercial purposes” means contacting or affecting such individuals to
facilitate, in any manner, for a profit-making activity. A request for a list of individuals where this is not
signed will be denied as per RCW 42.56.070(9).
For County Department/Office use only:
County Department/Office: Received By:
Date action taken: Name of person taking the action:
Special Circumstances:
Delivery Method: ___Mail
___Phone ___Fax ___Email ___In Person ___Other _________________