PDFWAC 132J-276-900

Appendix "A"Request for public record to College District No. 10.

APPENDIX "A"
REQUEST FOR PUBLIC RECORD TO
COLLEGE DISTRICT NO. 10
(a)
. . . .
Signature
. . . .
Signature (Please Print)
 
. . . .
Name of Organization, if Applicable
 
. . . .
Mailing Address of Applicant
. . . .
Phone Number
(b)
. . . .
Date Request Made at
College District No. 10
. . . .
Time of Day
Request Made
(c)
Nature of Request . . . .
 
. . . .
 
. . . .
 
. . . .
(d)
Identification Reference on Current Index . . . .
 
Please Describe
 
. . . .
 
. . . .
 
. . . .
(e)
Description of Record, or Matter, Requested if not Identifiable by Reference to College District No. 10's Current Index . . . .
 
. . . .
 
. . . .
 
. . . .
Request: Approved . . . .
By . . . .
 
Date
Public Records Officer
Denied Date . . . .
 
Reasons for Denial
. . . .
. . . .
Referred to . . . .
. . . .
By . . . .
 
Date
Public Records Officer
[Statutory Authority: RCW 28B.50.140 and 34.02.353 [34.05.353]. WSR 15-15-071, § 132J-276-900, filed 7/13/15, effective 8/13/15; Order 73-2, Appendix A (codified as WAC 132J-276-900), filed 5/14/73.]