Nolan Wheeler, Public Records Officer • email@example.com
1600 Maple Street • Longview, WA 98632
DECLARATION FOR NON COMMERCIAL
USE OF LIST OF NAMES
City, State & Zip Code
The undersigned, certifies and declares as follows:
1. I have requested access to and/or copies of the following public records from Lower Columbia
I understand that records I request from Lower Columbia College under the Public Records Act,
RCW 42.56 are not for commercial purposes.
3. I understand that the use for commercial purposes of said records may also violate the rights of
individuals named herein and may subject me to liability for such commercial use.
4. I have been informed that the Revised Code of Washington, RCW 42.56.070(9) prohibits
agencies from providing lists of individuals for a commercial purpose and understand that
violation of this certification constitutes false swearing under RCW 9A.72.040.
5. I understand that "for commercial purposes" means a business activity by any form of business
enterprise intended to generate revenue or financial benefit.
6. I understand that Lower Columbia College does not warrant nor in any way guarantee the
accuracy or completeness of its data.
7. Therefore, I do hereby certify and declare under penalty of perjury under the law of the state of
Washington that I will not use said records for commercial purposes and that, further, it is my
affirmative duty to prevent others from using said records for commercial purposes.
Date/ Place (city or county)
I have requested access to and/or copies of the described public records from Lower
Columbia College for the following purpose:
click to sign
click to edit