. . . . Name of Applicant |
. . . ., Mailing Address of Applicant | . . . . Phone Number |
. . . . Date Request Made at Washington State Convention and Trade Center | . . . . Time of Day of Request Made |
Nature of Request: . . . . |
. . . . |
. . . . |
. . . . |
Description of Record Requested: . . . . |
. . . . |
. . . . |
Said Records Have Not Been Requested to Provide Access to Lists of Individuals for Commercial Purposes. |
. . . . Signature | . . . . Signature (please print) |
Request: Approved | . . . . Date | By. . . . |
Denied Date: . . . . |
Reasons for Denial: . . . . |
. . . . |
Referred to. . . . | . . . . Date | By. . . . |
[Statutory Authority: RCW
42.17.250. WSR 83-06-035 (Order 2, Resolution No. 10), § 140-12-070, filed 2/28/83.]