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KPD Request for Notification of Firearm Release la 043016 Request for Notification of Firearm(s) Return (Sheena Henderson Act) Kennewick Police Department ♦ 211 W. 6th Avenue ♦ Kennewick, WA 99336 ♦ To request the Kennewick Police Department (KPD) to notify you when a family or household member will have a firearm(s) returned, complete this form and deliver it to the KPD as outlined below. The KPD 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. In order 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 relations, including stepparents and stepchildren and grandparents and grandchildren. Your Name Full name of Person From Whom Firearm(s) Was Taken Your Relationship to This Person Best Method to Reach You:  Phone ( )  Email KPD Case Number (REQUIRED) Date Firearm(s) Was Taken By The KPD Location of Incident Where Firearm(s) Was 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 mailed or hand delivered to the Kennewick Police Department, Attention Property & Evidence Custodian at: 211 W. 6th Avenue, Kennewick, WA 99336 ---PAGE BREAK--- KPD Request for Notification of Firearm Release la 043016