HomeUniversity PoliceReports, Records, and RequestsRecords RequestGRAMA Request Form (Police Reports) Records Request Request Made to Utah Tech University Police Department Note: Utah Code § 63G-2-204(1) (GRAMA) requires a person making a records request to furnish the governmental entity with a written request containing the requester’s name, mailing address, daytime telephone number, and email address if the person is willing to receive communications by email. The request must also include a description of the being record requested that identifies the record with reasonable specificity. The request must be made to the governmental entity that created or maintains the records. Requester information: Last Name * First Name * Date of Birth * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Daytime Phone Number * Email Address * Records Requested Note: The more specific the request, the easier it will be for records officers to respond. Incident report number (if known) Description of records including all relevant information -- date range of records, name of involved person(s), location of event(s), and other descriptive information: * Details for records that may have restricted access: Note: Some records may be classified as private, controlled, or protected, or access may be limited by another statute. Access to restricted records is provided for in the relevant other statutes or in Utah Code § 63G-2-202(1)(2)(4). Are you the subject of the record? * Yes No Are you an authorized representative of the subject of the record (parent, guardian, someone with power of attorney or notarized release) * Yes No Explain * Did you provide the record to the governmental entity? * Yes No Describe your connection to an incident or event that is the subject of the record * Details for records the release of which may be in the public interest: Note: Release of some records is in the public interest. Such records may be eligible for a fee waiver and/or expedited response as provided in Utah Code § 63G-2-203(4) and Utah Code § 63G-2-204(4)(5). This section is typically filled out by members of the media; it may not be applicable to your request. Does the release of these records benefit the public? * Yes No Are you requesting an expedited response? * Yes No Will the record be used for a news story or publication? * Yes No Which channel or publication? * Explain other justification that release of the record will benefit the public. * Details for records that may be eligible for a fee waiver: Note: Government entities are encouraged to waive fees in certain circumstances as outlined in Utah Code § 63G-2-203(4). Do you want this request to be considered for a fee waiver? * Yes No Are you the subject of the record? * Yes No Are you an impecunious (without money) individual whose legal rights are affected by access to re the requested records? * Yes No Additional access considerations: Note: Additional details about obtaining access to records are outlined in Utah Code § 63G-2-201, 203, and 204. Would you like the records to be provided in a particular format? * Yes No Explain * Do you want to be contacted if the cost of providing records exceeds a certain amount? * Yes No State the amount * $ Rather than receiving copies of the requested records, would you like to view them in the office of the governmental entity? * Yes No Arrangements must be made with the entity’s record officer. Explain anything else you would like to be taken into consideration regarding this request: * PLEASE READ THE FOLLOWING BEFORE SIGNING THIS REQUEST Your request for records will be processed in accordance with the requirements of the Government Records Access Management Act (GRAMA), Utah Code Section 3-2-101, et. seq. Your request will be handled as soon as reasonably possible, but may take up to ten business days as outlined in Utah Code § 63G-2-204(4)(b) or five days for expedited response. Records containing information that has been classified as “Private” or “Protected” or is otherwise restricted may be redacted or denied in accordance with GRAMA requirements. (Utah Code Section 63G-2-202.) I agree to pay a fee of $15.00 (per report) to cover the actual cost of research and duplicating a record if copies are requested. This fee is subject to change if extensive research and copies are requested. (Utah Code Section 63G-2-203.) I understand that I may request a fee waiver as permitted by Utah Code Section 63G-2-203. Pursuant to Utah Code Section 63G-2-203(5), a governmental entity generally may not charge a fee for: (a) reviewing a record to determine whether it is subject to disclosure, except as permitted by Subsection (2)(a)(ii); or (b) inspecting a record. Electronic Signature * Date Submit If you are human, leave this field blank.
