RAP FORM 16: PETITION AGAINST STATE OFFICER

(Rule 16.2(b))

No. (appellate court)

SUPREME COURT OF THE STATE OF WASHINGTON

(Name of petitioner), )

Petitioner, )

v. ) PETITION AGAINST STATE OFFICER

(Name of respondent), )

Respondent. )

Petitioner alleges:

(Set forth in numbered, descriptively titled paragraphs, as in a complaint in a civil action, a short and plain statement of the claim showing that petitioner is entitled to relief. Conclude with a demand for judgment for the relief sought. See CR 10.)

(Date)

___________________________________

Signature

Attorney for Petitioner

(Name, address, telephone number, and Washington State Bar Association membership number of attorney)