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NU. ` , OL '
RECORDS DISPOSITION DOCUMENT
PAGE ! OF PAGES
1. AGENCY NAME and ADDRESS 2. AGENCY CONTACT (Name and Tel phone
VILLAGE OF TEQUESTA
Number)
345 Tequesta Drive Lori McWilliams, MMC
Te
uesta, FL 33469 (561) 768-0443
3. NOTICE OF INTENTION: The scheduled records listed in Item 5 are to be disposed of in the manner
below (specify only one). specified
Oa. Shred at Department Level O c. Send to Storage until O e. Recycle
Disposition Date Met
Ob. Send to Storage for Shredding 0 d. Removed from Server O f. 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 ave been fully justified, and that further retention is not
required for any litigation pending or imminent.
• (o►2e. l e " b ce it a�
Signature Name and Title (Senior Staff Y) Date
5. LIST OF RECORD SERIES
a. b. C. d.
Schedule Item e. f. g.
Title Retention Inclusive Volume Disposition
No. No.
Dates in Action and
Cubic Date
Feet Completed
After
Authorization
GS1-SL 17 Village Manager's Monthly Reports 3 fy 2009-10 �, 1-6
GS1-SL
GS1-SL
GS1-SL
=GS1-SL
TOTAL CUBIC FEET THIS PAGE:
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.
modifications are indicated.
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l 2Jx>EG �4ssr; 1 ar
Records Liaison Officer Signature Date Signature 'La,r e!T"tle __-- Date
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1 e �-�
Routin
1. 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 storage
3. Originating department to dispose and document
column g, at the storage room and will contact Public Works to remove
then sends
records
a. Completed form to Village Clerk's Office for permanent 3. Clerk's Office will be responsible for final disposition of
archival
records at this point
OR Form Updated: 4/11/18