WAC 446-20-400. Form of request to inspect record

inspection of record request (RCW 10.97.080 /WAC 446-20-070 ) Agency . . . . Agency No . . . . Date . . . . Time . . . . I, . . . . . . . . . . . . , do hereby request to inspect my criminal history record information maintained in the files of the above named agency. In order to ensure positive identification as the person in question, I am submitting my fingerprints in the space below. (Fill in where applicable box) Because I am unable to read □; do not understand English □; other reason □; I hereby designate and consent that (Print Name) , whose address is . . . . . . . . . . . . . . . . , read or otherwise described or translated to me the criminal history record information concerning myself. . . . . . . . . Prints of right four fingers taken simultaneously (Signature or mark of Applicant) . . . . (Address) . . . . . . . . (Signature of Designee) Agency . . . . Agency No . . . . Date . . . . Time . . . . I, . . . . . . . . . . . . , do hereby request to inspect my criminal history record information maintained in the files of the above named agency. In order to ensure positive identification as the person in question, I am submitting my fingerprints in the space below. (Fill in where applicable box) Because I am unable to read □; do not understand English □; other reason □; I hereby designate and consent that (Print Name) , whose address is . . . . . . . . . . . . . . . . , read or otherwise described or translated to me the criminal history record information concerning myself. . . . . . . . . Prints of right four fingers taken simultaneously (Signature or mark of Applicant) . . . . (Address) . . . . . . . . (Signature of Designee)