Washington Administrative Code
Title 474 - State Treasurer's Office
Chapter 474-01 - Regulations assuring compliance by the state treasurer's office with the provisions of chapter 1, Laws of 1973, subchapter IV - Public records
Section 474-01-990 - Form - Request for public records

Date . . . . . . . . . . . .

Time . . . . . . . . . . . .

REQUESTED BY:

Name . . . . . . . . . . . .

Title . . . . . . . . . . . .

Address . . . . . . . . . . . .

Telephone No. . . . . . . . . . . . .

Representing . . . . . . . . . . . .

NATURE OF REQUEST:

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DETAILED DESCRIPTION OF DOCUMENT:

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(Signature)

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FOR OFFICE USE ONLY

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(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 the record: Subsection (1)().

(3)

If withheld, briefly explain how the exemption applies to the record withheld.

(4)

If request granted, time . . . . . . . . , date . . . . . . . . . . . .

Reviewed: . . . . . . . . . . . . Public Records Officer

(Initial)

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(Initial)

Deputy or Assistant State Treasurer