Records Transfer Form

Prepare and label boxes for transfer according to transfer procedures, then use this form to transfer records to the Records Center or the State Archives. A separate form must be submitted for each record series. List each box and include all descriptions such as date or file ranges.

We will contact you about delivery times after this form is received.

If you have questions, you may contact a storage specialist at
recordscenter@utah.gov or 801-525-3020. Or contact your RIM specialist at 801-531-3863.

Records Center mailing address
P.O. Box 141029
Salt Lake City, UT 84114-1029

Records Center physical address
Freeport Center, Building C-6
5th St. & C St.
Clearfield, UT 84015

State Archives address
346 South Rio Grande St.
Salt Lake City, UT 84101-1106

Agency Information

Agency Name Mailing Address Records Officer Name Records Officer Phone Person Submitting Form Email of Person Submitting

Record Series Information

Series Number Series Title

Inclusive Dates of Records Being Transferred From To

Total Boxes to be Transferred Transfer Includes Non-Paper Records Do you have an electronic index of files contained in this transfer?

Description of Records

For each box you are going to transfer, indicate your agency box number, the dates of what is in the box (from and to, in month/year format), and a summary of the box contents. There is no need to list each file in each box, however ranges of box contents are very helpful. Line numbers have been added for your convenience. Add as many lines to the form as you have boxes.

Example

Line, Your Box #, Dates of Contents (from and to, by month/year), Box Contents Summary (no need to list files) 1. 2004-1, from 8/1998 to 8/2000, invoices 100-200 2. 2004-2, from 9/2000 to 9/2002, invoices 201-300 3. 2004-3, from 10/2002 to 10/2004, invoices 301-400

To ease data entry, you may compile your list in word processing software, copy it and then paste it in the textbox below. Do not include a list of files with the boxes. Do include a range of contents per box.

Page Last Updated August 12, 2019 .