Digital to Microfilm Transfer Notification

To transfer images to the Archives for writing to microfilm, this form must be submitted once per film roll. If you have questions, you may email Brian Carpenter at bcarpenter@utah.gov or call 801-531-3830.

Agency Information

Name of person submitting form:
Agency:
Email:
Phone:

Record Series Information

Series Number:
Series Title:
Date or File Range for this submission:	from to

Roll Information

Scanner Number:
Roll Number:
How Many Images Are Being Transferred (including all pages in multi-page TIFF files):
Include Blipping of Images (optional):
Include Labeling of Images (optional):
Film Size:	16 mm, portrait 35 mm, portrait 35 mm, landscape
Special Instructions:

This page was last updated March 31, 2010.