HomeMy WebLinkAboutDispositions Forms_27-16_10/2/2019_FinanceRevised : 4/6/12
RECORDS DISPOSITION DOCUMENT
NO. pall' 1 Lf
PAGE 1 OF 1 PAGES
1.AGENCY
Village of Tequesta
2.DEPARTMENT
Finance
3.BUREAU
N/A
4. ADDRESS (Street, City, and Zip Code)
5. CONTACT (Name and Telephone Number)
345 Tequesta Drive
Lori McWilliams, MMC
Tequesta, FL 33469
561-768-0440
6. SUBMITTED BY: I hereby certify that the records to be disposed of are
7. NOTICE OF INTENTION
correctly represented below, that any audit requirements for the records
have been justified, and that further retention is not required for any
The scheduled records listed in Item 8 are to be disposed of in the
Iffigatio g or immi nt.
0) h
manner checked below (specify only one):
Da. Destruction 0 b. Microfilming and Destruction
Signat re Date
/Y/I/ (V
a.1 Shred Qa.2 Recycle
JoAn F rsythe, Fin nce Director
0 c. Imaging and Destruction
0 d. Other
Name and Title
8. LIST OF RECORD SERIES
a.
Schedule
Item
b.
Item
No.
C.
Title
d.
Retention
e.
Inclusive
Dates
f.
Volume
in
Cubic
Feet
g.
Disposition
Action and Date
Completed After
Authorization
GS1-SL
195
Payroll Records: Supporting Docs.
5 FYS
FY 2012
3
i
GS1-SL
340
Disbursement Records: Detail
5 FYS
FY 2012
1.5
iSQaS Yh aV\. :,
I r�l
rl
TOTAL CUBIC FEET:
9. DISPOSAL AUTHORIZATION: Disposal for the above listed records
authorized. Any deletions or modifications are indicated
Signature: Date. _
10. DISPOSAL CERTIFICATE The above listed records have been
disposed of in the manner and on the date shown in column g.
(Witness to the Records Disposition)
Signature: �j Date: 1 I
Print Name: Lori McWilliams
Print Name:
Print Title: Village Clerk
Print Title:
NOTE: Upon disposition retain this form for your records
Amended: 2/8/16