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FINALADMINISTRATIVE ADJUSTMENTRevised 10/01/15FORM Yakima County Public Services 128 North Second Street Fourth Floor Courthouse Yakima, Washington 98901 (509) 5742300 1800 5727354 FAX (509) 5742301
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01
To fill out the Final Administrative Adjustment Revised 100115, follow these steps:
1. Review the form and ensure you have all the necessary information and supporting documents.
02
Begin by entering the date on the top of the form in the specified format.
03
Provide your personal information, including your name, address, and contact details.
04
Specify the department or agency for which you are completing the form.
05
Enter the details of the original administrative adjustment that is being revised.
06
Describe the changes or adjustments you wish to make and the reasons for them.
07
Provide any additional supporting documentation or evidence to support your revisions.
08
Sign and date the form, affirming the accuracy and completeness of the information provided.
09
Review the completed form to ensure all fields are filled out properly and no errors or omissions are present.
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Submit the form to the appropriate authority or department as per their instructions.
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Anyone who has previously submitted an administrative adjustment and needs to make revisions or changes to it may need the Final Administrative Adjustment Revised 100115 form.
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