Laserfiche WebLink
aDrivMIISOUTONSIMDEPARNIIIIOt <br /> er and Plate Search (DAPS) and <br /> LICENSING Driver Information and Adjudication System (DIAS) <br /> Agency Access Request <br /> Agencies use this form to request access to the DAPS or DIAS systems.A person with authority to commit its <br /> organization to contractual obligations must sign this form. <br /> Email the completed application and documentation that identifies the designated contract administrator as an employee <br /> of your agency (examples:employee ID.credentials. badge. etc.)to: DataServices@dol.wa.gov <br /> •aline s stem access(select all that apply): <br /> 419 DAPS online driver and vehicle records search for use in investigations <br /> T-"• — online system to view and electronically update driver records used by courts, prosecuting attorneys, and <br /> government agencies. <br /> Agency name <br /> City of Everett Police Department <br /> ORI or NCIC number I EIN.TIN,or USI <br /> WA0310300 <br /> I Office name and location . <br /> City of Everett; Everett,Washington <br /> Physic of address(Siree.Apanment or stale number.City:Slate.ZIP code) <br /> 3002 Wetmore, Everett,WA,98201 <br /> Mailing address(Address or PO Box,City Stare.ZIP code) <br /> 3002 Wetmore, Everett,WA,98201 <br /> Account administrator name(person authorized to agree to the click-through contract)j Title —} <br /> Sandra Albertson Records Unit Manager <br /> Email (Area code)Telephone number <br /> salbertson@everettwa.gov 425-257-7454 <br /> Provide a detailed explanation of why you need driver or vehicle record information. Insufficient detail or specifics may <br /> cause your application to be rejected. <br /> Driver and Vehicle information is used by Everett Police Officers to assist with investigation of criminal cases.obtain information <br /> about stolen vehicles,and locate individuals that are missing or wanted by the police agency. <br /> Will you disclose the information to third parties? [i Yes ✓1 No <br /> If"Yes,"to whom and why? Be specific. <br /> No,the information is for official police use only. <br /> Do you have the authority to delegate the account administrator named above to agree to the <br /> contract terms and conditions? E Yes 0 No <br /> certify under penalty of perjury under the laws of the state of Wa •'•• e n :t the foregoing is true and correct. <br /> • <br /> g(8d-19-)�� X <br /> Date and place.gned Sig . .a urn e-,..sgrthere) Q�j� <br /> Mayor _ �, <br /> Tine `► <br /> For office use only , -- # <br /> Date received 1161C/1 5 ❑DIAS +DAPS Action taken:f Approved Li De: <br /> DSHS child support enforcement? ❑Yes END !/fad, <br /> gt t dispatchers? C Yes ❑No X/7 t � ,a 1Lict <br /> Sigr.atur of approver <br /> DSC-425.00.41a)WA I �� <br /> R9. <br /> ,P•ROVE0 �• S FORM ' <br /> � 4 <br /> t 14 AL City lerk�- <br /> •MES D.I it ttorney <br />