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2. REQUEST FOR MUNICIPAL COURT RECORDS
4. Last Name of Requestor*
5. First Name of Requestor*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Email Address*
18. INFORMATION REQUEST ON:
20. Last Name
21. First Name, Middle Name
23. Date of Birth
25. Court*

    1. Puyallup
    2. Milton
26. Case Number/s
28. REQUEST*

    I am requesting copies of the following documents (please be specific)*:

30. Documents requested (choose one):*

    1. Copies only (not certified)
    2. Certified copies
31. Copy of Audio Recording(s) Request (fee may apply)*

    List date/s requested

33. Declaration

    By affixing my electronic signature below, I hereby declare under penalty of perjury, under the laws of the State of Washington, that the name(s) and/or documents provided to me in this data shall not be used for any commercial purposes in violation of State law by myself or any organization I represent, and I will not allow access to this information by anyone who may use it for purposes of contacting individuals names therein or otherwise personally affecting them in the furtherance of any profit-seeking activity.

    I understand that if documents are not claimed within 30 days, reapplication and prepayment will be required including previous fee(s).

    Note:  Upon receipt of this request, the court will process those items which can be disclosed as soon as possible.  Before any information can be released, this form must be completed and payment of applicable fees - per local court rule:  PUMCLR 9.1 or LGR 2.3.*

35. 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.
37. Electronic Signature*
38. Date*
    Date
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field