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Public Records Request

  1. Individual:

  2. Attorney representing the:

  3. Insurer of the:

  4. Parent or legal guardian of minor involved as:

  5. I REQUEST:*


  7. I understand that Criminal History Information provided by the Mount Vernon Police Department and released to my custody will not be released to any UNAUTHORIZED persons pursuant to RCW 10.97, Washington State Criminal Records Privacy Act.*

  8. Leave This Blank:

  9. This field is not part of the form submission.