Form Center

3. Snohomish County Public Advocate
   

   Everett, WA 98201
   Inquiry Form
5. Name:
7. Address
9. City
10. State
11. Zip
13. Phone
15. Email
19. 1. Snohomish County department, division or service your inquiry is about:
21. 2. File, permit, record or other number, if applicable:
23. 3. County employees you have dealt with (name, position, agency):
25. 4. Witnesses/others involved (name, address, telephone number):
27. 5. Did you file an appeal or apply for a review? When? Results ?
29. 6. Summary of your inquiry (including steps you have taken to resolve problem and relevant dates:
31. 7. In your view, what would be the best way to resolve your inquiry?
33. Attachments to the Public Advocate:
35. I affirm that the above statement and facts are true and correct to the best of my knowledge.
37. Request for non-disclosure: I request that information revealing my identity not be disclosed pursuant to the provisions of RCW 42.56.240(2).
41. 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 PublicAdvocate@snoco.org  the form to us.
    
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

* indicates a required field