WAC 446-20-450. CHRI challenge form

chri challenge form (request for modification of chri) RCW 10.97.080 /WAC 446-20-120 agency . . . . agency case no . . . . . address . . . . date . . . . . . . . I, (Print Name) , Date of Birth hereby acknowledge receipt this date, . . . . . . . . , of a copy of a Washington State Patrol Criminal Records Division RAPsheet bearing SID number . . . . . . , consisting of . . . . page(s) and identified as a history of criminal offenses charged to me. I challenge the following specific portion(s) of the CHRI as being inaccurate or incomplete: agency . . . . agency case no . . . . . address . . . . date . . . . . . . . I, (Print Name) , Date of Birth hereby acknowledge receipt this date, . . . . . . . . , of a copy of a Washington State Patrol Criminal Records Division RAPsheet bearing SID number . . . . . . , consisting of . . . . page(s) and identified as a history of criminal offenses charged to me. I challenge the following specific portion(s) of the CHRI as being inaccurate or incomplete: Agency Case No. Date Charge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and request modification to read: I further request that the following designated persons or agencies who have received copies of the record be advised of the modifications. Agency Case No. Date Charge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and request modification to read: I further request that the following designated persons or agencies who have received copies of the record be advised of the modifications. . . . . (Signature of Requestor) Prints of right four fingers taken simultaneously together . . . . (Signature of Requestor) Prints of right four fingers taken simultaneously together