400-06-180 - Request for public record - Form

400-06-180. Request for public record - Form

STATE OF WASHINGTON

PUGET SOUND PARTNERSHIP

REQUEST FOR PUBLIC RECORD

Date of Request: . . . . . . . . . . . .

Requested By: . . . . . . . . . . . .

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Public Records or Information Requested: . . . . . . . . . . . .

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Requester Must Read and Sign:

  

I understand that I must abide by the rules and regulations published by the Puget Sound Partnership for the protection of public records, a copy of which I have read and understand.

  
  

I understand that I will be charged a reasonable fee to reimburse the partnership actual costs associated with fulfilling my request.

  

Requester's Signature . . . . . . . . . . . .

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Completed by Partnership Public Records Officer:

Date of Receipt: . . . . . . . . . . . .

Number of Copies: . . . . . . . . . . . .

Amount Received: $ . . . . . . . . . . . .

Reason if Partnership is Unable to Comply: . . . . . . . . . . . .

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Public Records Officer Signature: . . . . . . . . . . . .

Public records of the agency are provided for inspection and copying subject to the following regulations:

(1)

No person shall knowingly alter, deface, or destroy public records of the partnership.

(2)

Original copies of public records of the agency shall not be removed from the offices of the partnership.

(3)

Care and safekeeping of public records of the partnership, furnished pursuant to a request for inspection or copying, shall be the sole responsibility of the requestor.

(4)

Records furnished for public inspection or copying shall be returned in good condition and in the same file sequence or organization as when furnished.

(5)

Boisterous or otherwise disruptive conduct by those requesting public records of the partnership shall not be permitted.

I have read, understand, and will comply with the above-stated regulations.

  

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(Signature and date)

Statutory Authority: Chapter 90.71 RCW. 10-12-009, § 400-06-180, filed 5/20/10, effective 6/20/10. Statutory Authority: RCW 42.17.250 through 42.17.320, 1985 c 451 and chapter 90.70 RCW. 86-04-055 (Order 86-02, Resolution No. 5), § 400-06-180, filed 2/3/86.

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