Woods Cross City
Government Records and Management Act (GRAMA)
Request for Records
To request information that is maintained by this office, please provide the following:
Name: _________________________________________________________
Address:________________________________________________________
City, State, Zip Code:______________________________________________
Phone#__(_____)_________________________________________________
E-mail Address___________________________________________________
Description of record(s) sought: (records must be described with reasonable specificity)
□ I would like to inspect the records.
□ I would like to receive copies of the records.
□ I understand that I will be responsible for copies or other costs up to $___________.
I further understand that the agency will contact me if estimated costs are greater
than the amount specified, and that the agency will not respond to a request or
copies if I have not authorized adequate costs.
□ I request a waiver of copy costs. (Please attach information supporting your request:
see U.C.A. 63-2-203 (3) for a list of situations under which an agency is encouraged
to provide copies without charge.)
□ I am requesting an expedited response. (Please attach information showing your
status as a member of the media and a statement the records are required for a
story, broadcast or publication; or please attach other information that demonstrates
you are entitled to an expedited response under U.C. A. 63-2-204(3).
Check one of the following and attach required documentation if necessary:
□ The record is a public record available for my review.
□ 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. (Attach copy of authorization.)
□ Other, Explain _______________________________________________________
_____________________________ _____________________________
Signature Date
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