Section I - IDENTIFICATION. The
information requested in Boxes 1
through 4 is not mandatory. If
provided, it will allow the Records
Officer to contact you, if necessary, in
connection with your request.
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DATE
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| 1. Name of
Requester |
2. Representing (if applicable)
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3. Street Address |
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4. City-State-Zip
Code
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If there is any particular urgency
attached to this request, please
indicate the date by which
you need the information.
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Section II - NATURE OF REQUEST. Please be specific
about the records you wish to see. If you do not know
the name of the records, make your request in the form of
a question. To comply with RCW 42.17.260(5)
(noncommercial use), please sign the certification below.
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| I certify that the information obtained as a result of this
request for public records will not be used in whole or in
part to compile a list for commercial purposes. |
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Requester's Signature |
DO NOT FILL IN BELOW THIS LINE
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Section III - REQUEST FOR REVIEW
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| Requested
by |
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Office
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Telephone
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Section IV - DISPOSITION OF REQUEST
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2.
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3.
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4.
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| 5. |
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6.
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7.
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8.
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9.
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