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Records Request Form

2. Description of Records Sought

   Records must be described with reasonable specificity.

4. Request Type

   1. I would like to inspect (view) the records.
   2. I would like to receive a copy of the records. I understand I may be responsible for fees associated with copying charges or research charges as permitted by Utah Code (UCA) 63-2-203.

6. I authorize costs of up to:

8. UCA 63-2-203 (4) encourages agencies to fulfill a records request without charge. Based on UCA 63-2-203 (4), I am requesting a waiver of copy costs because:

   1. Releasing the record primarily benefits the public rather than a person. Please explain.
   2. I am the authorized representative of the subject of the record.
   3. My legal rights are directly affected by the record, and I am impoverished.

10. Why does the release of the record primarily benefit the public rather than a person?

12. Please include information supporting your request for a waiver of the fees.

14. Non Public

    If the requested records are not public, please explain why you believe you are entitled to access.

    1. I am the subject of the record.
    2. I am the person who provided the information.
    3. I am authorized to have access by the subject of the record or by the person who submitted the information. Documentation required by UCA 63-2-202, is attached.
    4. Other.
16. Documentation required by UCA 63-2-202

18. Other. Please explain.

20. Expedited Response

    1. I am requesting expedited response as permitted by UCA 63-2-204 (3)(b).

21. Please attach information that shows your status as a member of the media and a statement that the records are required for a story for broadcast or publication; or other information that demonstrates that you are entitled to expedited response.

23. Requestor's Name

25. Mailing Address

27. Daytime Phone Number

28. Date
    Date

30. Signature

Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field