Santaquin City Police - Request for Record(s)

Santaquin Police - Request for Record(s)

Government Records Access and Management Act (GRAMA)

Santaquin Police Department Phone: 801-754-1070
275 W Main, Santaquin, Utah 84655 Email: police@santaquin.gov

Utah State Code allows for up to 10 business days to provide the requested record, a denial, or a notice of extended time for response to a records request (UCA 63G-2-204).

Name of Requester:*

Date of Birth:*

Date

Address:*

Phone:*

Email:

example@example.com

Please mark ONE of the following. I WOULD LIKE TO:

Inspect (view) the records

Receive copies of the records. I understand that I am responsible for the costs of providing the records as permitted by UCA 63-2-203 and authorize costs not to exceed as specified below. I further understand that I will be contacted if the estimated costs are greater than the amount I have specified, and that the police department will not provide records for which I have not authorized adequate costs.

Dollar amount authorized not to exceed:

ex: $100.00

I would like to receive copies of the records and request a waiver of costs. (Please attach information supporting your request UCA 63G-2-203(4) as a file upload) (Does not guarantee waiver will be granted.)

File Upload of Information Supporting your Request:

Case Number/Description of records sought: (Describe in detail the records you are requesting, including applicable addresses, dates, names, & DOB.)*

If applicable, check ONE of the following and attach necessary documentation: (You may be asked to provide an ID.)

1) I am the subject of the record.

2) I am the person who provided the information.

3) I am authorized to have access by the subject of the record or by the person who submitted the information. (Provide authorization UCA 63G-2-202 as a file upload. See below.)

File Upload of Authorization

4) Other - Please describe below:

Other

5) I am requesting an expedited response. (Please attach information that shows your status as a member of the media and that the records are required for a story, for broadcast or publication; or other information that demonstrates you are entitled to expedited response under UCA 63G-2-204(5) as a file upload. See below.)

File Upload of Media Status

I acknowledge that secondary dissemination to any unauthorized agency or person is PROHIBITED.

Signature:*

Upload photo of valid drivers' license:*

Date:*

Date