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Cedar City Records Request Form

  1. Requester Information:

  2. Status:

  3. Record Request Forms are Public Documents

  4. FOR OFFICE USE ONLY:

    Date Received: ____________________________
    Time Received: ____________________________ AM or PM


    CLASSIFICATION OF RECORD REQUESTED:
    ( ) Public
    ( ) Private
    ( ) Protected
    ( ) Controlled


    CITY RESPONSE TO RECORD REQUEST:
    ( ) Released on: __________________
    ( ) Denied (See Attached) __________________
    ( ) Request for Extraordinary Circumstances (See Attached).


    FEE CHARGED:__________________

    SIGNATURE OF RECORD PROVIDER ____________________________________

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  6. This field is not part of the form submission.