Firearm Return Notification FILLABLERequest for Notification of Firearm(s) Return
(Washington State HB 1715)
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To request the Port Orchard Police Department notify you when a family or household member will
have a firearm(s) returned, complete this form, and deliver it to the Port Orchard Police Department as outlined herein.
The POPD will provide notice within one business day to you the requirements for release have been met and the
individual is requesting release of the firearm(s). The firearm(s) will be held for 72 hours after notification is sent and
then released.
Please note that the agency considers notification to be made when the message is sent using the method(s)
prescribed herein.
To qualify for notification of a firearm(s) return, you must be a family or household member of the individual from
whom the firearm(s) was taken. RCW 26.50.010 defines a family or household member as:
• Spouses or former spouses.
• Domestic partners or former domestic partners.
• Persons who have a child in common regardless of whether they have been married or have lived together
at any time.
• Adult persons related by blood or marriage.
• Adult persons who are presently residing together or who have resided together in the past.
• Persons sixteen years of age or older who are presently residing together or who have resided together in
the past and who have or have had a dating relationship.
• Persons sixteen years of age or older with whom a person sixteen years of age or older has or has had a
dating relationship; and
• Persons who have a biological or legal parent -child relationship, including stepparents and stepchildren and
grandparents and grandchildren
Your Full Name
Full Name of Person from Whom Firearm(s) Was Taken
Your Relationship to This Person
The best method to reach you:
❑ Home ( 1 ❑ E-Mail
❑ Cell ( 1
POPD Case No.
Date Firearm(s) Was Taken by the
POPD
Location of Incident Where Firearm(s) Were Taken
I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct to the
best of my knowledge, information, and belief and that I qualify as a family or household member as defined above. I
understand that if I knowingly make a request for notification under Chapter 9.41 RCW based on false information, I
may be held liable under RCW 9A.76.175 (making a false or misleading statement to a public servant).
Signature of Requestor Date
Completed forms may be e-mailed to the Port Orchard Police Department at police(cDportorchardwa.aov or delivered
in person or by sent by mail at (Attention: Records/Evidence Specialist) to our address below:
Port Orchard Police Department 546 Bay Street Port Orchard, WA 98366