Government Records Access
and Management Act

NOTICE TO PROVIDER OF INFORMATION

This notice describes how personal information you may be asked to provide is used by the County when that information could be classified as private or controlled under the Government Records Access and Management Act (GRAMA).

As a client of the Agency Name office you are entitled to receive notice about our information collection practices. It is important for you to understand that information you provide as a requirement to receive services may be classified as Private and Controlled under the Government Records Access and Management Act.

What is private and controlled information? These are records or other documents held by Salt Lake County which includes personal information such as home address, home telephone number, birth date, social security number, certain medical or financial information, entitlement to social services, home ownership and living conditions, and similar items of a personal nature.

Why are you being asked to provide private and controlled information? In order to more efficiently provide government services the Agency Name requests your private information in order to do the following:

Use Statement

What is the County’s intended use of this information?
Agency Name collects personal data in order to meet specific statutory requirements.

What are the consequences for refusing to private and controlled information? If you choose to refuse to provide information requested or required by our agency, you may not be eligible to receive our services.

Who does the County share this information with?
Agency Name shares information with: Share Information

 

Agency Name
2001 South State Street Suite
Salt Lake City, UT  84190
Contact: Contact Name
Phone: 801 468-3000
Email