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2. All records requests must be reviewed by the City Clerk.
   City Clerk's Office
   10220 270th Street NW
   Stanwood, WA 98292
   
   Phone: 360-629-2181
   Fax: 360-629-3009
6. Please describe the records you are requesting, and provide any additional information to help locate the records as quickly as possible. Use appropriate document title and date, if known.
8. I would like to:

   1. Inspect the records at no charge (I may request copies after inspection).
   2. Receive copies of the records after paying required copying charges.
10. I am willing to pay up to this amount ($) for those copies.
    Regular copies are 15 cents per page. Other fees may apply.
14. Limitation on Use for Commercial Purposes
    Washington State Law, Revised Code of Washington 42.56.070(9) prohibits the use of lists of individuals for commercial purposes. "Commercial Purposes" means that the person requesting the record intends that the list will be used to communicate with the individuals named in the record for the purpose of facilitating profit-expecting activity. By signing this form, you are certifying that the lists of individuals obtained through this request for public records will not be used for commercial purposes.
18. First Name
19. Last Name
21. Address
23. City
24. State
25. Zip Code
27. Phone Number
28. Email Address
30. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
32. Electronic Signature
33. Date
    Date
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit Submit and Print

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