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WAC 389-12-990	No agency filings affecting this section since 2003
Appendix A — Form — Request for public records.

  


APPENDIX A


REQUEST FOR PUBLIC RECORDS

Name of Requestor:
Address:				Phone:
Date of Request:				Time of Request:
Nature of Request:
1. Index Reference. . . . . . . . . . . . . . . . . . . . . . . . . .
2. If not identifiable by reference to the index, then describe the document(s) in detail . . . . . . . . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . .
			Signature. . . . . . . . . . . . . . . . . . .
For Office Use Only:
(1)	Request Granted	Record Withheld		Record Withheld In Part
(2)	If withheld, name the exemption contained in section 31, chapter 1, Laws of 1973, which authorizes the withholding of the record or part of record: Subsection (1) ( ).
(3)	If withheld, briefly explain how the exemption applies to the record withheld.
(4)	If request granted, time. . . . . . , day. . . .

[Order XII, Appendix A -- Form (codified as WAC 389-12-990), filed 11/28/73.]