322-12-160 - Adoption of form

322-12-160. Adoption of form

The commission on Hispanic affairs hereby adopts for use by all persons requesting inspection and/or copies of records the form set out below, entitled "Request for public records."

We have received your request for copies of our public records. Please complete the form on the right and return it with the amount required. We will forward the requested copies to you as soon as we receive this form.

Thank you.

Return to:

Commission on Hispanic Affairs 210 11th Avenue S.W., Suite 301A

Olympia, WA 98504-0924

Commission on

Hispanic Affairs

REQUEST FOR PUBLIC RECORDS

Date . . . . . . . . . . . .

Time . . . . . . . . . . . .

Name . . . . . . . . . . . .

Address . . . . . . . . . . . .

. . . . . . . . . . . .

Description of Records (see index):

. . . . . . . . . . . .

. . . . . . . . . . . .

. . . . . . . . . . . .

I certify that the information obtained through this request for public records will not be used for commercial purposes.

  

. . . . . . . . . . . .

  

Signature

Number of copies

. . . . . . . . . . . .

  

Number of pages

. . . . . . . . . . . .

  

Per page charge

. . . . . . . . . . . .

  

Total charge

$ . . . . . . . . . . . .

  

Statutory Authority: RCW 43.115.040. 08-07-001, § 322-12-160, filed 3/5/08, effective 4/5/08; Order 1, § 322-12-160 and form, filed 12/9/74.

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