PERSON REQUESTING

Name

Company

Mailing Address

City, State, ZIP

Telephone Number (    )                                            FAX Number (    )  

NAME/DESCRIPTION OF PUBLIC RECORD

CONDITIONS FOR RELEASE OR REVIEW OF PUBLIC RECORDS

Records are available for inspection in the presence of the commission’s authorized staff and copies will be made with the aid and assistance of that staff from 9:00 a.m. to 12noon and from 1:00 p.m. to 4:00 p.m. Monday through Friday, excluding legal holidays and public Commission meeting days. Records exempt from disclosure under RCW 42.17, RCW 42.30, or RCW 42.56 will not be provided.  

If I wish to inspect or review record(s), I agree to the following conditions:

¨      The quantity of records may be limited.

¨      I will not remove the records from the designated area.

¨      I will not mark or alter the records in any way.

¨      I will not destroy or deface the records in any way including writing on, folding or folding anew if in folded form, tracing or fastening with clips or other fasteners except those that already exist in the file.

¨      I will not cut or mutilate records in any way.

¨      I will keep the records in the order received.

¨      I will return the records to staff when no longer required by me and no later than the end of customary office hours on the day provided.

¨      I will not be allowed to inspect records or have records copied if I am intoxicated, violent, abusive, threatening, or otherwise disruptive. If I display these characteristics during records inspection, staff will terminate my privileges.

_________________________________________________                   ____________________________________

Signature of Person Requesting Public Document                                                                    Date

Signature Authorizing  Release of Records  

                                          Date                                                  

Minimum copy charge— $.15/page in excess of 20 pages.

 Number of copies ________

Cost per copy    $.15 per page

Date person contacted

Date request completed

TOTAL DUE          $__________

Comments Below