Utah Code 53G-10-103 (HB374)Reporting Tool
This reporting tool is to be completed by LEAs who have received a complaint regarding instructional materials according to:

Please only complete this form after a decision has been made about the instructional material's retention or removal.
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Email *
First and Last Name *
School District or Charter *
Job Title/Position *
Date Complaint Received *
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Level of Complaint *
If school- or classroom-level complaint, name of school.
Title of Material *
Author of Material *
Complaint Submitted By: *
Required
Reason(s) provided for complaint. Be specific -- feel free to copy/paste from complainant's request. *
District/School Action Taken (check all that apply): *
Required
Was the book reviewed as a whole? *
Were parents who are reflective of the members of the school's community included in the determination?  *
District/School Decision Made: *
Required
Date of Final Decision *
MM
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DD
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YYYY
Provide the rationale for retaining or removing the material. *
Additional Notes (Optional)
Submit
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