Public Records Request Form

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To submit your request for Public Records, fill out this form as completely as possible.

"*" indicates required fields

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.*

I would like to:*

Inspect the records at no charge (I may request copies after inspection).

Receive copies of the records, required copying charges of $0.15 per page will apply, or as specified in Cowlitz PUD’s Public Records Act Policy.

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number

Email Address*

Limitation On Use For Commercial Purposes

Washington State law, RCW 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 below, you are certifying that the lists of individuals obtained through this request for public records will not be used for commercial purposes.

Do you consent to signing this document electronically?

Yes

Full Name (Digital Signature)

Date

Security Check

Public Records Request Form

ADDRESSES

OFFICE ADDRESS

MAILING ADDRESS

PHONE NUMBERS

MAIN OFFICE

OUTAGES

QUICK LINKS