Fillable Printable Public Disclosure Request - Seattle Police Department
Fillable Printable Public Disclosure Request - Seattle Police Department
Public Disclosure Request - Seattle Police Department
Seattle Police Department
Public Disclosure Request
Form 21.7 Rev 7/11
Public Request Unit * 610 5
th
Ave, PO Box 34986 * Seattle, WA 98124-4986
Phone (206)684-5481* Fax (206) 684-5240* email spdpdr@seattle.gov
Name:
Address (address/city/state/zip)
Email Address
Incident Information
Date of Incident Time of Incident
Location of Incident
Investigating Officer Serial Number
GO Number
Description of record(s) requested. Please specify your request by checking the appropriate box(es) below and adding detail
in the space provided, if applicable.
Incident Report 911 Call Video Follow-up Other:
I prefer to receive these records in the following format:
Electronic (CD/DVD/Scanned Documents)-will incur cost of the media/scanning costs.
Paper copy (Fifteen cents per page for requests exceeding 20 pages). There is no charge for requests under 20 pages. A letter with
the amount due will be mailed to you once the records are available for release. The records will be mailed once full payment is
received.
View by appointment (No charge for viewing records by appointment).
X
Requestor’s Signature Today’s Date
Official Use Only
Date Received: Received by: (Ser#) PDR#
ID Verified Serial # Date:
