HomeMy WebLinkAboutDispositions Forms_09-21_4/5/2021_FireNO. 07-21
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
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 specified
below (specify only one).
a. Shred at Department Level O c. Send to Storage until O e. Recycle
Disposition Date Met
Ob. 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.
�kz I)A Amy Lori McWilliams, Village Clerk 02/05/21
Signature Name and Title (Senior Staff only) Date
5. LIST OF RECORD SERIES
After the Item #, 3face an ".a" for record vo ,or "b" for duplicate.
a.
Schedule
b.
Item
C.
Title
d.
Retention
e.
Inclusive
f.
Volume
g.
Disposition
No.
No.
Dates
in
Action and
Cubic
Date
Inset
Feet
Completed
or"b"
After
after item
# (247b)
Authorization
GS1-SL
242a
RUO
11/2020-12/2020
.02
31l/oU
`
o r tC�
TOTAL CUBIC FEET TF"S PAGE:
6. DISPOSAL AUTHORIZATION: Disposal for
7. DISPOSAL CERTIFICATE: The above listed records have been
the above listed records is authorized. Any
dispo d f in the manner and on the date shown in column g.
eletions or modifications are indicated.
�y aFa
�,C• a�
Records Liaison Officer Signature Date
Signature NarttelTitle ^� ,�` ate
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
4. Completed form to Village Clerk's Office for permanent
records
3. Clerk's Office will be responsible for final disposition of
archival
records at this point Form Updated: 4111/18, 1126121
OR