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Get Third Party Release Form - Utah Department Of Public Safety - Publicsafety Utah

If you wish to have your criminal history record or certificate of eligibility sent to an individual other than yourself, you must indicate the name of the person or agency to whom you would like the document sent and the mailing address. NAME: (Name of Person to Receive Report) AGENCY: (if applicable) MAILING ADDRESS: (Street/Box number) (City) (State) (Zip) I request that the criminal history record or certificate of.

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