Fillable Public Records Request Form (City of Duvall)

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Public Records Request Form (City of Duvall)

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The Public Records Request Form (City of Duvall) form is 1 page long and contains:

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  • 6 check-boxes
  • 10 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Duvall

BROWSE CITY OF DUVALL (WA) FORMS

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form updated 9/26/17
Received Stamp
City Clerk’s Office
cityclerk@duvallwa.gov
15535 Main Street NE
PO Box 1300 ● Duvall, WA 98019
425-788-1185 ● FAX 425-788-8097
www.duvallwa.gov
Public Records Request Form
This form must describe an identifiable record. The City is not required to create a new record to comply with the Public
Records Act. This form is not intended for general inquiries or information requests. Information provided on this form may
be subject to public disclosure. For questions, please contact the City Clerk at cityclerk@duvallwa.gov or 425-788-1185.
SECTION 1 – TO BE COMPLETED BY REQUESTING PARTY
Name:
Daytime Telephone #:
Mailing Address:
Email:
City, State, Zip:
Preferred method of communication regarding
this request: Email Telephone
Describe the records you are requesting. Please supply as much identifying information as possible to assist staff in locating
the records quickly. Examples: specific dates or date ranges, document titles, names, addresses, parcel numbers. Use additional
sheet(s) if necessary.
Record Type/Size - Paper
Charge
8.5” x 11” up to 11" x 17'' (color or b/w)
$0.15/page
24" x 36'' (color or b/w)
$3.89/page
Record Type/Size - Electronic
Charge
Scanning into electronic format
$0.10/page
Electronic files or attachments
$0.05/four files
Electronic Transmission
$0.10/GB
CD-R (700MB)
$0.28
DVD (4.7 GB)
$0.90
USB flash drive (2 GB)
$3.50
I would like paper copies requested? How many copies
of each item is requested:
I would like to inspect the records before requesting
copies. Please indicate a preferred day/time, M-F 8:30am-
4:30pm:
For records available electronically, I prefer
Flash Drive CD.
Please note: Digitization of records may be done by an outside
vendor if digitization would adversely impact normal and essential
operations of the City. The requester may be responsible for the
related costs.
Signature required:
I understand and agree that the City of Duvall will charge a fee according to the fee schedule for copies assembled and
made by the City’s staff. Charges for copies of documents requiring special reproduction shall be in accordance with the
amount necessary to reimburse the City for its actual costs. Payment is required before release of records.
I agree (certify) that I will not use lists of individuals for commercial purposes (for profit) nor permit others to use said
records for commercial purposes per RCW 42.56.070(9).
Signature:
Date:
SECTION 2 – FOR CITY USE ONLY
Received by:
Five-Day Date:
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Public Records Request Form (City of Duvall)

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Completed 13 November 2021

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