OKANOGAN COUNTY – REQUEST FOR PUBLIC RECORDS

Requester’s Name:  _______________________________________________________________

Mailing Address:  _________________________________________________________________

                                                Street              City                  State                                        Zip

Daytime Phone Number:  __________________________  Email:  __________________________

Description of records (Please be as specific as possible.  If known, include author, recipient, title, date or date range, etc.)

List each Department, Office or Official having custody of the records requested:

After the County retrieves the requested records, I request:

[  ] Inspection Only                  [  ]  Copy All                [  ]  Inspection, then copy selected pages

(Standard copies are 15 cents per page.  There is no charge to inspect documents)

Date desired:  _________________ [Most requests are filled within five business days]

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.  I understand and acknowledge that Okanogan County does not warrant the accuracy or completeness of information contained in public records or any data provided electronically.

____________________     _______________________   _________________________________

Date                                          Place                                     Signature