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Request For Information - Washington

Request For Information Form. This is a Washington form and can be used in Miscellaneous District Court King Local County .
 Fillable pdf Last Modified 9/15/2014
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Department of Judicial Administration Barbara Miner Director and Superior Court Clerk (206) 296-9300 (206) 296-0100 TTY/TDD REQUEST FOR INFORMATION / DATA DISSEMINATION Please complete and return this form to: Department of Judicial Administration 401 Fourth Ave N, Room 2 C, Kent, WA 98032-4429 The information you provide below is necessary to process your request for data from the Judicial Information System. Your request is subject to approval under the provisions of JISCR 15 and the Judicial Information System Data Dissemination Policy and the local Data Dissemination Policy and Procedures. Upon approval, the request will be forwarded to a programmer who will examine it and contact you to work out any necessary details. There is a charge for such reports as governed by JISC policy. If you have questions about this form, please contact the Data Dissemination Coordinator at (206) 205-8433. Name (Please Print): Agency or Company: Address: City: Day or Work Phone: ( ) State: Fax No: Zip: Information Requested (provide as much detail as possible): What will the information be used for? To whom will the data be disseminated? If this information concerns a named individual, please give necessary identifying information: Date needed: Medium Requested: Paper Disk I certify under penalty of law that all the information supplied above is a true and complete description. Signature of Requestor: Date: Other comments from requestor: C:\Users\sbernstein\Downloads\Data_Dissemination_Form.doc American LegalNet, Inc. www.FormsWorkFlow.com
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