Public Records Request

Date and Time

Requestor Information

Name

First

Middle

Last

Address

Street

City

State

Zip Code

Contact Information

Telephone

Fax

Email Address

Signature

Description of Requested Record(s) - Please use additional sheets as necessary. It is important to be as specific as possible to name, location, date, and type of record requested.

This is a request to inspect on site the records identified above.

This is a request for copies of the records identified above to be sent to you.

Other…

(1) The Administrative Records Officer will respond within five (5) working days from receipt of this request.

(2) GR 31.1 (h) authorizes agencies to charge for the actual cost of reproducing documents, or .15 cents per page if actual cost has not been determined, plus packing and mailing costs. The charge for copying 50 pages or less is waived.

(3) OCLA encourages electronic submission of requests for public records. If you are able to, please send the records request to ocla@ocla.wa.gov.

Please use this space of additional sheets are needed.

Underwriting Justice • Ensuring Accountability

Public Records Request

Requestor Information

Name

Address

Contact Information