PDFWAC 132L-276-900
Appendix "A"—Request for public record to Centralia College.
REQUEST FOR PUBLIC RECORDS | |||||||||||
To: | Public Records Officer | date of request | time of request | ||||||||
Centralia College | . . . . | . . . . | |||||||||
public records or information requested | requested by | ||||||||||
name: | |||||||||||
. . . . | |||||||||||
organization: | |||||||||||
. . . . | |||||||||||
mailing address: | |||||||||||
. . . . | |||||||||||
. . . . | |||||||||||
. . . . | |||||||||||
requester read and sign | |||||||||||
. . . . | |||||||||||
completed by public records officer | acknowledgment of receipt | I understand that I must abide by the rules and regulations published by Centralia College for the protection of public records, a copy of which I have read and understand. | |||||||||
no. of copies | amount received | date of receipt | time of receipt | ||||||||
. . . . | . . . . | . . . . | . . . . | ||||||||
public records officer signature | recipient's signature | ||||||||||
. . . . | . . . . | ||||||||||
reason if unable to comply: | I understand that I will be charged per copy for all standard letter size copies I desire and that other size publications are available at cost. | ||||||||||
. . . . | |||||||||||
requestor's signature | |||||||||||
Public records of Centralia College are provided for inspection and copying subject to the following regulations: | |||||||||||
WAC 132L-276-120 Protection of public records. | |||||||||||
(1) | No person shall knowingly alter, deface, or destroy public records of Centralia College. | ||||||||||
(2) | Care and safekeeping of public records of Centralia College, furnished pursuant to a request for inspection or copying, shall be the sole responsibility of the requestor. | ||||||||||
(3) | Records furnished for public inspection or copying shall be returned in good condition and in the same file sequence or organization as when furnished. | ||||||||||
(4) | Boisterous or otherwise disruptive conduct by those requesting public records of Centralia College shall not be permitted. | ||||||||||
I have read, understand, and will comply with the above-stated regulations. | |||||||||||
. . . . | |||||||||||
Requestor's Signature and Date | |||||||||||
[Statutory Authority: RCW 28B.50.140 and chapter 34.05 RCW. WSR 04-19-062, § 132L-276-900, filed 9/15/04, effective 10/16/04; Order 73-20, Appendix A (codified as WAC 132L-276-900), filed 5/18/73.]