Utah Department of Administrative Services

Division of Archives & Records Service

Series-Specific Retention Schedule Submission Form

Information About Records

*Record series title (no acronyms/abbreviations):


Variant title (acronyms or nicknames):


*Date ranges:


* Arrangement:

Alphabetical by

Alphanumerical by

Chronological by

Numerical by

Database

Other Arrangement:

 

*What government functions do the records document?

*How are the records used?

*What information is contained in them?

If there is a legal citation that governs these records, please provide:

Retention & Disposition

Do these records follow a General Retention Schedule?

    Yes
    No

Designation & Classification

GRAMA (Utah Code § 63G-2-307)(1)(c)) states that a governmental entity shall report designations of its records to the State Archives.

Primary designation for the record series:

    Public
    Private
    Controlled
    Protected
    Restricted by a court rule or a state or federal statute other than GRAMA

If not Public, provide the legal citation which is the basis for the designation for records in the series.

See classification worksheet.

Secondary designation for the record series:

    Public
    Private
    Controlled
    Protected

Your Contact Information

*Records Officer's Name:
*Email address:
*Phone number:
*Name of governmental entity:
Division (include city/region):

 

Provide any other comments you have related to these records: