NOTE: The Word version of this form is made available as a working document for the convenience of rule filing agencies. To file a rule, an agency must use the division's online rule filing application, eRules.

State of Utah

Notice of EFFECTIVE DATE
DAR file no: / Date filed:
State Admin Rule Filing Id: / Time filed:
Agency No. / Rule No. / Section No.
Utah Admin. Code Ref (R no.): / R / - / -
Changed to Admin. Code Ref. (R no.): / R / - / -
1. / Agency:
Room no.:
Building:
Street address 1:
Street address 2:
City, state, zip:
Mailing address 1:
Mailing address 2:
City, state, zip:
Contact person(s):
Name: / Phone: / Fax: / E-mail:
(Interested persons may inspect this filing at the above address or at DAR between 8:00 a.m. and 5:00 p.m. on business days.)
2. / Title of rule or section (catchline):
3. / Effective date (The effective date must be no fewer than seven days after the close of the public comment period, nor more than 120 days after the publication of the rule in the Utah State Bulletin. A notice of effective date may NOT provide for a retroactive effective date -- the date on which the notice is received by the Division is the earliest effective date that may be assigned):
The rule or change described on this form is effective and enforceable on (mm/dd/yyyy):

eRules v. 2: EffectiveDate.doc 09/03/2009 (http://www.rules.utah.gov/agencyresources/forms/EffectiveDate.doc)