Wash. Admin. Code § 132D-276-140 - Adoption of form
The district hereby adopts for use by all persons requesting inspection and/or copying or copies of its records the following form:
REQUEST FOR PUBLIC RECORD TO
COMMUNITY COLLEGE DISTRICT NO. 4
(a) |
. . . . . . . . . . .. Name (please print) |
. . . . . . . . . . .. Signature |
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. . . . . . . . . . .. Name of Organization, if Applicable |
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. . . . . . . . . . .. Mailing Address of Applicant |
. . . . . . . . . . .. Phone Number |
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(b) |
. . . . . . . . . . .. Date Request Made |
. . . . . . . . . . .. Time of Day Request Made |
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(c) |
Nature of Request . . . . . . . . . . .. |
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(d) |
Identification Reference on Current Index (Please describe) |
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(e) |
Description of Record, or Matter, Requested if not Identifiable by Reference to the Community College District No. 4 |
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Request: |
APPROVED . . . . . . . . . . .. |
DENIED . . . . . . . . . . .. |
Date . . . . . . . . . . .. |
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By |
. . . . . . . . . . .. Name |
. . . . . . . . . . .. Title |
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Reasons for Denial: . . . . . . . . . . .. |
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Referred to . . . . . . . . . . .. |
Date . . . . . . . . . . .. |
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By |
. . . . . . . . . . .. Name |
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Notes
Statutory Authority: RCW 28B.50.140. 89-11-024 (Order 89-07), § 132D-276-140, filed 5/11/89.
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