Fillable Records Request Form printable pdf download

Records Request Form

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Records Management Department

Bellevue School District

P.O. Box 90010

Bellevue, WA 98009-9010

Phone (425) 456-4223

Fax (425) 456-4157

Bellevue School District

RECORDS REQUEST FORM

I. IDENTIFICATION

Name of Requestor

Date of Request

Time of Request

Representing (if applicable)

Email Address

Phone

Street Address

City

State/Zip Code

II. RECORDS REQUEST

Please be specific in defining in the space below the records you wish to inspect or have copied. If you do not know the

specific name of the records you desire, indicate by a general written description of the type and content of information

you wish to locate. Where possible, indicate limiting dates, topic, and person(s) referenced. Attach additional pages if

necessary.

 Request inspection only, including electronic (no fee)

 Request for copies (see fees below)

I hereby certify that the information obtained as a result of this request for public records will not be used for commercial

purposes.

Requestor's Signature______________________________________________________________________

Records Request Form

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