WAC 491-20-990:

WACs > Title 491 > Chapter 491-20 > Section 491-20-990

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491-20-100 << 491-20-990 >> End of Chapter

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)						Record Withheld In Part □
		Request Granted □		Record Withheld □
(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 II, Appendix A (codified as WAC 491-20-990), filed 7/5/77.]