Requestor’s Date Requested_______________
Signature________________________________ Date Completed________________
DUPLICATION FEE $_________________
COMPLITATION FEE $_________________
Record’s Officer Signature____________________________
TOOELE COUNTY
GRAMA Request Form
Utah Code § 63G-2-204
Requester’s information
Name:_________________________________________________________Date:_________________________
Address:________________________________________City/State/ZIP:_________________________________
Email Address ___________________________________Telephone number:____________________________
Records requested
Note: The more specific and narrow the request, the easier it will be for our office to respond to the request.
Description of records including all relevant information—location of event(s) described in records, city, county,
address; date range of the records; names of the person(s); and subject of the request.
I am the subject of the record
I am the authorized representative of the subject of the record
I provided the information in the record
I would like to:
View or inspect the records only
Receive a copy of the records and pay associated fees to compile and/or duplicate in conformance with
Tooele County’s policy as determined by ordinance or adopted written formal policy.
o Please notify me if the amount will exceed $___________________
o I would like to receive documents via email
Receive a copy of the records and request a fee waiver, according to Utah Code § 63G-2-203, because:
____My legal rights are directly implicated by the information of the record, and I am impoverished
Receive an expedited response (5 days) because releasing the records benefits the public; I request the
information for a story or report for publication or broadcast to the general public
