Snohomish County, WA - Official Website

Name:

Address

Phone

Email

1. Snohomish County department, division or service your inquiry is about:

2. File, permit, record or other number, if applicable:

3. County employees you have dealt with (name, position, agency):

4. Witnesses/others involved (name, address, telephone number):

5. Did you file an appeal or apply for a review? When? Results ?

6. Summary of your inquiry (including steps you have taken to resolve problem and relevant dates:

7. In your view, what would be the best way to resolve your inquiry?

I affirm that the above statement and facts are true and correct to the best of my knowledge.

Request for non-disclosure: I request that information revealing my identity not be disclosed pursuant to the provisions of RCW 42.56.240(2).

Please contact the Public Advocate's Office if you have any questions about how to fill out this form. Once you have filled out and signed your complaint, you may mail (Public Advocate’s Office, 3000 Rockefeller Ave., MS 401, Everett, WA 98201) or scan and email [email protected] the form to us.

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