Washington Administrative Code
Title 415 - Retirement Systems, Department of
Chapter 415-06 - Public records
Section 415-06-110 - Adoption of form
The director hereby adopts for use by all persons requesting inspection and/or copying or copies of the department records, the form attached hereto as Appendix A, entitled "Request for public record."
APPENDIX A
REQUEST FOR PUBLIC RECORDS
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Name of Requestor: |
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Address: |
Phone: |
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Date of Request: |
Time of Request: |
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Nature of Request: |
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1. |
Index Reference . . . . . . . . . . . . |
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2. |
If not identifiable by reference to the index, then describe the document(s) in detail . . . . . . . . . . . . |
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Signature |
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For Office Use Only: |
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(1) |
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Request Granted [] |
Record Withheld [] |
Record Withheld In part [] |
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(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) (). |
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(3) |
If withheld, briefly explain how the exemption applies to the record withheld. |
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(4) |
If request granted, time. . . . . . . , day. . . . . . . . . |
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Order 4, §415-06-110, filed 7/27/77.
