Records Request Form
**IF YOU ARE REQUESTING A POLICE DOCUMENT EXIT THIS FORM AND FILL OUT THE POLICE REPORT REQUEST (GRAMA)**
This is located on the city website under transparency tab
Requestor Information
Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Date
*
/
Month
/
Day
Year
Date
Time
Requested Record Status (check all that apply)
*
The requested record is a public record.
I am the subject of the requested record.
I am the parent or legal guardian of the subject of the requested record.
I am the provider of the information in the requested record.
I have a “power of attorney” or notarized release from the subject of the record, or from the provider of the information in the requested record.
I have a legislative subpoena or court order requesting the record.
Description of Requested Record (use additional sheets if necessary)
*
Agreement:
In requesting this record, I understand and agree to the following: I will pay costs associated with the provision of the record (copies are 25 cents per page, certified copies $5.00 per page, compilation time will be charged at a rate of $20.00 per hour. I will allow a maximum of ten (10) working days for Lindon City to compile the record, or five (5) days if I show that such expedition will benefit the public more than my person. I will recognize that this completed Records Request Form is a public document.
*
Date
*
-
Month
-
Day
Year
Date
Preview PDF
Submit
Should be Empty: