HomeMy WebLinkAboutDispositions Forms_54-19_10/9/2019_Human ResourcesNO. 54-19
RECORDS DISPOSITION DOCUMENT
PAGE 1 OF 1 PAGES
1. AGENCY NAME and ADDRESS
2. AGENCY CONTACT (Name and Telephone
VILLAGE OF TEQUESTA
Number)
345 Tequesta Drive
Lori McWilliams, MMC
Tequesta, FL 33469
(561) 768-0443
3. NOTICE OF INTENTION: The scheduled records listed in Item 5 are to be disposed of in the manner specified
below (specify only one).
Qa. Shred at Department Level U c. Send to Storage until ® e. Recycle
Disposition Date Met
b. Send to Storage for Shredding ® d. Removed from Server Of. Other
4. SUBMITTED BY:
I hereby certify that the records to be disposed of are correctly represented below, that any audit requirements for the
records have been fully ju tified, and that further retention is not required for any litigation pending or imminent.
'
Human Resources Director 10/09/19
Signature Name and Title (Senior Staff only) Date
5. LIST OF RECORD SERIES
a.
b.
C.
d.
e.
f.
g.
Schedule
Item
Title
Retention
Inclusive
Volume
Disposition
No.
No.
Dates
in
Action and
Cubic
Date
Feet
Completed
After
Authorization
GS1-SL
3
Administrative Convenience Records
OSA
2011-2016
.2
TOTAL CUBIC FEET THIS PAGE:
.2
6. DISPOSAL AUTHORIZATION: Disposal for
7. DISPOSAL CERTIFICATE: The above listed records have been
the above listed records is authorized. Any
disposed of in the manner and on the date shown in column g.
deletions or modifications are indicated.
Lori McWilliams Dale: YS'9"�816:08: 6-04a00' 10/08/19
oei�:zo,9.,o.oa,c:oesa-oa•oo•
°igia1y&gp0.0816Lon W"0400 Village Clerk 10/08/19
Lori McWilliams ��,:�,9.,o.�,fi:�:<,_��
Records Liaison Officer Signature Date
Signature Name/Title Date
,,
<; R�:�.
,.
i. Originates with Department Senior Manager, then
1. Originates with Department Senior Manager, then
2. Village Clerk's Office authorizes disposition, and returns to
2. Village Clerk's Office authorizes disposition and/or storag,
3. Originating department to dispose and document column
at the storage room and the "Clerk's Office" will contact
"nnrtnino�inry A--+ +0,A
r) .I., ;,. 1A1....G a— a,.I— IL —
I`