20080326 Public Records Request 062609CITY OF YELM
REQUEST FOR ACCESS TO PUBLIC RECORDS
The following information is to be filled out by the person requesting records:
Date of Request: ,Z.~ ~~~n~ ~~
Name of Person Making Request: ~~'~-~~ `,'~ ~~~
Address: ~ -S .3.3 °l ~ ~~ ~' Y~~ L ~-
City: ~ [Z-~ State: ~ ~ Zip: ~)g.S -7 Phone: ~.1~ SZcI '~ 71 ~
If this is an emergency request, indicate the date desired and please describe the nature v/the
emergency:
RECORDS REQUESTED: (Please state the title and date of the record(s) being
requested):
Please describe any additional information that will help us locate the records as quickly as
possible:
Requestor's
Uate: ~ Y~ V-~
For City Use Only
Staff person receiving request: Date:
Number of Copies: Total Charge:
Staffperson who provided records:
Date: Client name receiving records:
ds-word/forms!publ icrecordsrequest forni. doc
RECEIVED
JUN 2 ~ 1009