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2. To: Washington County Sheriff's Office - Records Dept
4. Today's Date*
   Today's Date
6. Date of Incident*
   Date of Incident Start Date

   —

   Date of Incident End Date
7. Case #, If known
9. Names of subject involved with this case?*
11. I hereby request, pursuant to Idaho Code §74‐102, to examine and / or copy the following public records:*
    Any known details of this call?
13. (§74‐103 must respond to request for record in 3 days or 10 working days.)

    1. These records specifically pertain to myself
    2. These records pertain to a family member related to myself
    3. These records pertain to an acquaintance of mine
    4. I wish to merely examine these records
    5. I wish copies of these records
15. Your Name*
17. Address of where you want the records mailed*
19. City*
20. State*
21. Zip Code*
23. Email Address (if you want these records emailed)
25. Phone*
27. Electronic Signature*
    I acknowledge by my signature that the records sought by this request will not be used for a mailing list or telephone list as set forth in Idaho Code § 74‐102.
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field