REQUEST FOR PUBLIC RECORDS | |||||||||||
To: | Public Records Officer | DATE OF REQUEST | TIME OF REQUEST | ||||||||
Centralia College | . . . . . . . . . . .. | . . . . . . . . . . .. | |||||||||
PUBLIC RECORDS OR INFORMATION REQUESTED | REQUESTED BY | ||||||||||
NAME: | |||||||||||
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ORGANIZATION: | |||||||||||
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MAILING ADDRESS: | |||||||||||
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REQUESTER READ AND SIGN | |||||||||||
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COMPLETED BY PUBLIC RECORDS OFFICER | ACKNOWLEDGMENT OF RECEIPT | I understand that I must abide by the rules and regulations published by Centralia College for the protection of public records, a copy of which I have read and understand. | |||||||||
NO. OF COPIES | AMOUNT RECEIVED | DATE OF RECEIPT | TIME OF RECEIPT | ||||||||
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PUBLIC RECORDS OFFICER SIGNATURE | RECIPIENT'S SIGNATURE | ||||||||||
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REASON IF UNABLE TO COMPLY: | I understand that I will be charged per copy for all standard letter size copies I desire and that other size publications are available at cost. | ||||||||||
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REQUESTOR'S SIGNATURE | |||||||||||
Public records of Centralia College are provided for inspection and copying subject to the following regulations: | |||||||||||
WAC 132L-276-120 Protection of public records. | |||||||||||
(1) | No person shall knowingly alter, deface, or destroy public records of Centralia College. | ||||||||||
(2) | Care and safekeeping of public records of Centralia College, furnished pursuant to a request for inspection or copying, shall be the sole responsibility of the requestor. | ||||||||||
(3) | Records furnished for public inspection or copying shall be returned in good condition and in the same file sequence or organization as when furnished. | ||||||||||
(4) | Boisterous or otherwise disruptive conduct by those requesting public records of Centralia College shall not be permitted. | ||||||||||
I have read, understand, and will comply with the above-stated regulations. | |||||||||||
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Requestor's Signature and Date |
Wash. Admin. Code § 132L-276-900
Statutory Authority: RCW 28B.50.140 and chapter 34.05 RCW. 04-19-062, § 132L-276-900, filed 9/15/04, effective 10/16/04; Order 73-20, Appendix A (codified as WAC 132L-276-900), filed 5/18/73.