Washington Administrative Code
Title 434 - Secretary of State
434-690 - Archives—Access to public records.
434-690-99001 - Appendix B—Form—Request for public records.

PDFWAC 434-690-99001

Appendix B—Form—Request for public records.

appendix b

request for public records

Name of Requestor:
Address:Phone:
Date of Request:Time of Request:
Nature of Request:
1. Index Reference . . . .
. . . .
. . . .
. . . .


Signature . . . .
For Office Use Only:
(1)

Request

Granted □

Record

Withheld □

Record

Withheld

In Part □

(2)If withheld, name the exemption contained in RCW 42.17.310 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 . . . . . . .

[Statutory Authority: RCW 42.17.250. WSR 91-23-024, § 434-690-99001, filed 11/12/91, effective 12/13/91.]

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