HomeMy WebLinkAboutDispositions Forms_12-20_10/21/2020_Human ResourcesNO -ao
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).
0 a. Shred at Department Level 0 c. Send to Storage until 0 e. Recycle
Disposition Date Met
b. Send to Storage for Shredding 0 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
recor s have been fully justified, and that further retention is not required for any litigation pending or imminent.
(l,V ` Lori McWilliams, Clerk 10/21/20
Signature Name and Title (Senior Staff only) Date
a.
b.
Schedule
No.
Item
No.
C. d.
Title Retention
e.
Inclusive
f.
Volume
g.
Disposition
Dates
in
Action and
Cubic
Date
Feet
Completed
After
GS1-SL
162
DUPLICATES -PERSONNEL RECORDS:
NON-FLORIDA RETIREMENT SYSTEM (LOCAL OSA
5
Authorization
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GOVERNMENT)
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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.
letions or modifications are indicated.
U
10/21 /20
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1
Records Liaison Officer Signature Date
Signature Name/Title Date
Originates with Department Senior Manager, then 1. Originates with Department Senior Manager, then
Village Clerk's Office authorizes disposition, and returns to 2. Village Clerk's Office authorizes disposition and/or storag
jOriginating department to dispose and document column g, i at the storage room and will contact Public Works to remov
then sends records ,
Completed form to Village Clerk's Office for permanent i 3. Clerk's Office will be responsible; r final disposition o
records at this point
,i pdated: 4/11i18%