City Recorder

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Records Request

Requester

Name

Address

Daytime Telephone

Section I

In accordance with the Governmental Records Access Management Act, I am requesting

to inspect to copy a certified copy of

the following records: (Must be very specific)

I understand that the cost of copying, certifying and research are my responsibility and authorize cost up to $

Copies--$0.25 per page; Certifications--$2 each;
Research, 1-15 minutes--no charge; over 15 minutes--$30 per hour.

Section II

If records requested are not public, explain why you believe you are entitled to access:

I am 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. (Affidavit required by UCA 63G-2-202).
Other (explain)

Section III

I am requesting expedited response. (Please be aware that additional information that shows your status as a member of the media and/or a statement that the records are required for a story for broadcast or publication; and/or information that demonstrates that you are entitled to expedited response under Layton City Code 4.01.204(3) will need to be submitted later.)

Section IV

DIGITAL SIGNATURE
I CONFIRM that the above information is correct.

Enter Your Full Name 04/16/2024 12:45 PM