HomeMy WebLinkAboutDispositions Forms_04-21_3/9/2021_ClerkNO. _ r
RECORDS DISPOSITION DOCUMENT
PAGE 1 OF 1 PAGES
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1. AGENCY NAME and ADDRESS 2. /,GENCY CONTACT (Name an,'-tephone
VILLAGE OF TEQUESTA dumber)
345 Tequesta Drive Lori McWilliams. MMC
Tequesta. FL 33469 (561) 768-0443
3. NOTICE OF INTENTION: The scheduled records liste m Item 5 are to be disposed of ie manner specified
below (specify only one).
Oa. Shred at Department Level O c. Send to Storage until e. Recycle
Disposition Date Met
0 b. Send to Storage for Shredding O 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 justified, and that further retention is not required for any litigation pending or imminent.
\ Lori McWilliams, Village Clerk 01/26/21
Sig ature 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.
I I
Dates
in `
Action and
Cubic 4
Date
Feet
Completed
1
After
Authorization
GS1-SL
172
Real Property Records
3 FY
1921-2001
.10
p
TOTAL
CUBIC FEET TKIS PAGE:
JC)
6. DISPOSAL AUTHORIZATION: Disposal for
7. DISPOSAL CERTIFICATE: The above listed records have been
the above listed records is authorized. Any
disposed o in he manner and on the date shown in column g.
�_ddletions or rnodiflcations are indicated.
iit, 94 81-m
M �u�
+ Signature Name; itle ck4c Date
Records Liaison Officer Signature Date
Routing:
1. Originates with Department Senior Manager, then 1
1. Originates with Department Senior Manager. then
2. Village Clerk's Office authorizes disposition, and returns to 12.
Village Clerk's Office authorizes disposition andJor storage
3. Originating department to dispose and document column g,
at the storage room and will contact Public Works to remove
then sends
records
4. Completed form to Village Clerk's Office for permanent
3. Clerk's Office will be responsible for final dsition of
archival
records at this point
Form Updated: 4t11/18 �
OR