TEST Records Transfer Request Form (Copy)

Transfer or Recall Records

Ready to send your boxes?

Fill out this form to request to send boxes to the State Records Center (in Clearfield), or to transfer boxes to State Archives (in Salt Lake City).

Please complete a new form for each series and for each shipment of boxes.

For electronic records, please use this form and make arrangements with your RIM specialist.

Supervisor looking over the work of the employee with them on a computer

Records Transfer Request Form

    Agency Information

    Your name

    Your email

    Your phone number

    Records officer name (the person at your agency who is appointed as the records officer. Look up records officer here.)

    Records officer email

    Records officer phone number

    Agency name

    Mailing address

    Record Series Information

    Record series number

    Record series name

    Box Information

    Inclusive dates of all boxes being transferred

    From:
    To:

    Total number of boxes being transferred

    Are there any non-paper records in this transfer?

    YesNo

    Please explain

    For each box, provide a summary containing the line number, user box number, date range, and a summary of contents

    Example 1:

    1. 2024-56, 2018-2019, Cases 52830-53728

    2. 2024-57, 2019-2020, Cases 53729-54183

    Example 2:

    1. BFB-113, 2016-2023, Peterson through Stevens

    2. BFB-114, 2016-2023, Stone through Wilson

    Box Summary

    Please provide a file inventory for each box and place a paper copy inside the box. An electronic copy helps us with other workflows, but should not replace the paper copy in the box.

    A file list is required for permanent records and optional (but advisable) for temporary records.

    Have multiple files? Merge PDFs here or learn how to create a zip file

    Enter URL

    Not applicable

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