Chewelah, WA · Stevens County
Incident Report Form
This form lets people report an incident to the City of Chewelah and provide contact details, the incident location, and a description.
What this form is
The Incident Report Form lets a person report an incident to the City of Chewelah. It collects the person's name, address, phone number, best time to call, incident location, description, signature, and date. City staff use the office-only section to record receipt, classify the incident as new or established, note action, and record whether and when it was resolved.
Who needs it
A person who wants to report an incident to the City of Chewelah can complete the form with their contact information and incident details.
How to submit it
The form lists the City of Chewelah at PO Box 258 – 301 E. Clay, Chewelah, WA 99109, and phone 509-935-8311; it gives no submission method.
About notarization
This document is signed without a notary; the signer just signs and dates the form.
How to submit this form
- 1
Download The Form
Download the City of Chewelah Incident Report Form PDF.
- 2
Complete The Form
Enter your contact details, the incident location and description, then sign and date the form.
- 3
Check Your Information
Review your entries for completeness. The form does not list required attachments.
- 4
Submit To The City
The form lists the City at PO Box 258 – 301 E. Clay, Chewelah, WA 99109, but does not state how to submit it.
Frequently asked questions
- What information does the Incident Report Form request?
- It asks for your name, address, phone number, best time to call, incident location and description, plus your signature and date.
- How do I submit the Incident Report Form?
- The form lists the City of Chewelah at PO Box 258 – 301 E. Clay, Chewelah, WA 99109, and phone 509-935-8311, but does not state a submission method.
- Do I need a notary for the Incident Report Form?
- No. The form has a signature and date field but no notary block; the signer just signs and dates it.