UTAH COUNTY GOVERNMENT
GRAMA REQUEST FOR RECORDS
To: _______________________________________________________
(Name of person and/or government office holding records)
Address of government office: ________________________________
Description of records sought (records must be described with reasonable specificity):
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
________________________________________________ ____________ _____ _____ _____ _________________
_____________________________________________________________________________________________
I would like to inspect the records
I would like to receive a copy of the records. I understand that I will be responsible for copy costs.
I authorize costs of up to $ __________________.
I would like to receive a copy of the records and request a waiver of copy costs because:
Release of the records primarily benefits the public rather than me.
I am the subject of the record.
I am the authorized representative of the subject of the record.
My legal rights are directly affected by the record and I am impecunious.
(Please attach information supporting your request for waiver of fees.)
If the requested records are not public, please explain why you believe you are entitled to access.
I am the subject of the record.
I am the person who provided the information.
I am authorized to have access by the subject of the record or by the person who submitted
the information. (please attach documentation required by U.C.A. §63G-2-202.)
Other. Explain: ___________________________________________________
I am requesting an expedited response. (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
please attach other information that demonstrates that you are entitled to expedited response under
U.C.A. §63G-2-204(3).)
My name is: __________________________________________________________________________
My address is: _________________________________________________________________________
City, State, Zip Code: ___________________________________________________________________
My daytime telephone number is: _________________________________________________________
_______________________________________ ___________________
Signature Date
My email address is : ______________________________________________________________________________
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