HomeMy WebLinkAboutDispositions Forms_47-18_8/2/2018_Human ResourcesRECORDS DISPOSITION DOCUMENT
PAGE OF I PAGES
1. AGENCY NAME
VILLAGE OF TEQUESTA
DEPARTMENT: }�,vrn0+n �„go�,� cg
2. AGENCY CONTACT (Name and Telephone
Number)
Lori McWilliams, MMC
(561) 768-0443
3. NOTICE OF INTENTION: The scheduled records listed in Item 5 are to be disposed of in the manner checked
below (specify only one).
Qa. Shred 0 b. Imaging and Destruction O c. Recycle
Od. Removed from Server 0e. Other
4. SUBMITTED BY:
I hereby certify that the records to be disposed of are correctly represented below, that any audit requirements for the
record ve been fully justified, and that further retention is not required for any litigation pending or imminent.
Si4nature Name and Title (Senior Staff only) Date
5. LIST OF RECORD SERIES
6.
a.
Schedule
No.
b.
Item
No.
C.
Title
d.
Retention
e.
Inclusive
Dates
f.
Volume
in
Cubic
Feet
9-
Disposition
Action and
Date
Completed
After
,Authorization
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TOTAL CUBIC FEET THIS PAGE:
7. DISPOSAL AUTHORIZATION: Disposal for
the above listed records is authorized. Any
deletions or modifications are indicated.
8. _ DISPOSAL CERTIFICATE: The above and below listed records have
been disposed of in the manner and on the date shown in column g.
(Wit ss to the records disposition)
f n &&'00/Y" lrla�q
Signature Date
Custodian/Records Liaison Officer Date
Name and Title
Form Updated: 1/3/17