10-1.5 Security Access Application.pdf

Security Access Application Instructions

This form must be filled out accurately and completely to determine what access may be authorized. Incomplete or falsified information may result in the application being rejected.

Submission of a form does not imply access will be approved. Application processing may take up to five (5) business days to complete.

1. Please fill out this form in its entirety

Section 1 - “Social security #” is not required but helpful

Section 2 - “Sheriff Sponsor” is Marco Morley or LT. Chris Hansen

“Sheriff Office Division” is Facilities Division.

Section 3 - Background check performed

Section 4 - Please include a legible color copy of the front of your driver’s license for submittal. Please do not send a picture of your DL. Please scan a color copy.

Section 5 - Please “wet or digitally Sign” the document

2. Do not send a picture of this application. It will not be accepted.

3. Please send the application and the DL together in the same email. This will help us submit it correctly.

4. If the applicant has a "LIMITED-TERM or DRIVING PRIVELEDGE CARD" an Employment authorization card must be included with the application when submitted.

5. You may turn this application in at the jail administration security desk or you can email it to the following addresses:

ADC-lobby@saltlakecounty.gov cphansen@saltlakecounty.gov mmorley@saltlakecounty.gov

6. If there is a denial, you or your management team will be notified. If you disagree with the “denial for access” you may appeal the decision by communicating with the security officer and will be given instructions on the process of appeal.

mailto:ADC-lobby@slco.org mailto:cphansen@SLCO.org mailto:mmorley@slco.org

Revised July 2025 GRAMA - Public Retention - 1 YR

Section 1: Personal Information:

First Name: Middle Name: Last Name:

Maiden / Alias:

Date of Birth: Driver’s License #: DL State: Social Security #:

Gender: Ethnicity: Height: Weight: Hair: Eyes:

Email: Personal Contact Number: Home Address:

Section 2: Access Reason / Employment:

Reason Access Requested:

Employer: Supervisor:

City / State / ZIP:

Contact Number: Email:

Sheriff’s Office Sponsor: Sheriff’s Office Division:

Section 3: Background Information:

As part of the application process, a criminal background check will be conducted. Access to the facility will be granted or denied based on the results of this background check and in accordance with jail policies and security protocols.

Section 4: Driver’s License Copy:

Section 5: Signature:

By signing below you consent to and understand a background check will be performed by Sheriff’s Office personnel to verify the information above.

***JAIL SECURITY DIVISION USE ONLY***

Section Complete Check Result Decisions Yes / No Section 1 SO# ASU Deputy Section 2 CHQL Signature Section 3 DLQL Security Lt.

Section 4 QSWL Signature Section 5 OTRKL Appeal Date Date Received QH2 Captain Date Completed QW1 Signature

***ADMINISTRATION USE***

Access Level Approved Term Support Notified Investigations Notified Temporary / Tour Days:

Incidental 1 Year Regular 1 Year Doctors 1 Year

Notes:

This form must be filled out accurately and completely to determine what access may be authorized. Incomplete or falsified information may result in the application being rejected. Submission of a form does not imply access will be approved. Application processing may take up to five (5) business days to complete.

Signature: Date: