HomeMy WebLinkAboutDispositions Forms_73-21_8/23/2021_ClerkNO. -7 3 - a I
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).
Oa. 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
rec r s have een fully justified, and that further retention is not required for any litigation pending or imminent.
Lori McWilliams, Village Clerk 08/12/21
Signature Name and Title (Senior Staff only) Date
5. LIST OF RECORD SERIES
After the Item #, place an "a" for record copy or "b" for duplicate.
a.
Schedule
No.
b.
Item
No.
C.
Title
d.
Retention
a
Inclusive
f.
Volume
g
Disposition
Dates
in
Action and
Insert "a"
Cubic
Date
or 'b"
afteritem
Feet
Completed
247b)
After
Authorization
GS1-SL
23a
Information Request Records
1 FY
Jan 2017-Dec 2018
.30
S�1 t� a✓�3
TOTAL CUM FEET THIS RAGE: o
6. DISPOSAL AUTHORIZATION: Disposal for
7. DISPOSAL CERTIFICATE: The above listed records have been
the above listed records is authorized. Any
eletijo� o�r�moodi�fications are indicated.
disposed of irfihe manner and on the ate s wn in column g.
0)414Aith(�Alt
Signature Name/Title Date
Routin :
cords Liaison Officer Signature Date
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
4. 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
Form Updated: 4/11118, 1126/21
OR