HomeMy WebLinkAboutRecords Request - OTH Record Requests - 5/29/2014 05/29/2014 THU 11: 46 FAX Q001/001
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PUBLIC RECORDS REQUEST FORM Da
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Received By:
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Address 7?— � ` ` Fax 360 _`71/7Z_ 35-1
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Record(s) requested: Please describe a speck identifiable record. Include document name, number or date if known.
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❑ I would like to inspect the record(s) at no charge
I would like a copy of the record(s): ❑ Mailed ❑ Faxed blgmailed (if available In electronic format) ❑Picked up
Please allow 5 business days for a response to your request. RCW 42.56.520
1 agree to pay all copy charges pursuant to Mason County's fee schedule. RCW 42.56.120
1 certlfy the Information obt fined thro th request will not be used for commercial purposes. RCW 42.56.070(8)
Requestor Signature Date
OFFICIAL USE ONLY
❑_ No responsive record Was located.
13 The record is exempt from disclosure pursuant to RCW (attach exemption log)
0 Portions of the record are exempt from dlsclosure and h:aye been redacted pursuant to RCW.
❑ Request forwarded to -
❑ 5 day response Date.,
Number of pages Fees Due$ ..... ❑ Payment received
Completed By: Date:
Reeurds were:GI Mailed ❑ Faxed ❑'Emailed ❑ Picked up