Name: _______________________________________________Phone: __________________

Address:______________________________________________________________________

Email: _______________________________________________Fax: ____________________

Building Address and Type: ______________________________________________________

Legal Description (Please attach a copy of the deed, contract, title report, or other full legal description, if available): ________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Approximate date constructed, if known: ____________ Source: ________________________

Current owner: _________________________________________ Date acquired: __________

Please list all prior ownership or other information known:

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________.

I request that Walla Walla 2020 perform a search of the records maintained by Walla Walla County, Pioneer Title Company, and Penrose Memorial Library at Whitman College regarding the above property, and provide me with a written report showing the information available from those sources regarding the names and occupation of all owners, and the best estimate of the construction date of the building listed above, for my use in documenting information to be contained in an historic building plaque I may order separately from 2020. I understand the fee for reports is $100 for residential buildings and $150-250 for commercial buildings (depending on the property), and enclose a check made out to Walla Walla 2020 Research in the amount of $________.

I agree that Walla Walla 2020 may make the report public by placing it libraries, including it on internet sites, or publishing it in other formats along with similar reports, and that both Walla Walla 2020 and I may make such other use of the report as each deems appropriate.

________________________________________

Signature     Date