Name Phone Email Name of person who was killed by law enforcement Your relationship to the person who was killed, if any Name of the officer/s that used deadly force The law enforcement agency that employed the officer Agency case number Date of incident Original investigating agency or independent investigative team County where the use of force occurred Prosecutor’s office that originally reviewed the case, if any Did the prosecutor issue a written opinion about the incident? N/A Yes No Brief description of the event Detailed description of the new evidence Will you be mailing additional material to OII? Yes No Washington State Office of Independent Investigations P.O. Box 40270 Olympia, WA 98504 C/O Prior Investigations Review Team Please include a note with your name, contact information, and the name of the person killed in this incident. Have you previously requested a review of this case? Yes No If so, which organization, office, or firm did you ask? Is there any other information you think we should know? Submit
