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HomeMy WebLinkAboutDispositions Forms_06-22_4/15/2022_UtilitiesNO. RECORDS DISPOSITION DOCUMENT PAGE / OF k PAGES 1. AGENCY NAME and ADDRESS 2. AGENCY CONTACT (Name and Telephone VILLAGE OF TEQUESTA Number) 345 Tequesta Drive Lori McWilliams, MPA, MMC, (561) 768-0443 or Tequesta, FL 33469 Mary Ann Grieser, CMC, (561) 768-0445 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 0 c. Send to Storage until e. Recycle Disposition Date Met 0 b. Send to Storage for Shredding 0 d. Remove from Server 0 f. Other 4. SUBMITTED BY (Department Head/Senior Staff Member Only): I hereby certify that the records to be disposed of are correctly represented below, that any audit requirements for the records havebeen fulhjustified, and that fu her retention is not required for any litigation pending or imminent. 4.,Mwo�,-0 IA N, i0va _ I t. _ Sign ture Name and Title (Dept. Head/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. Dates in Action and Cubic Date Feet (Completed After Authorization SG1-SL 17 Corespondence and Memoranda: 3 FY 1986 .01 F6 Administrative 1989 © y-IS as SG1-SL 17 Corespondence and Memoranda: 3 FY 1999 .02 Administrative 2002 SG1-SL 17 Corespondence and Memoranda: 3 FY 2000 .03 Administrative 2003 SG1-SL 17 Corespondence and Memoranda: 3 FY 2001 .02 Administrative 2004 SG1-SL 17 Corespondence and Memoranda: 3 FY 2002 .01 Administrative 2005 TOTAL CUBIC FEET THIS PAGE: .69 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. eletions or modifications are indicated. X` U 4)"e, y1-11n I Clerk's Office Signature Date Signature of Person Disposing of Records Name/Title Date 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 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:9/21/21 OR I Continuation Page a. Schedule No. b. Item No. C. Title d. Retention e. Inclusive Dates f. Volume in Cubic Feet 9. Disposition Action and Date (Completed After Authorization SG1-SL 17 Corespondence and Memoranda: Administrative 3 FY 2006 2003 .02 &Jcfed SG1-SL 17 Corespondence and Memoranda: Administrative 3 FY 2012 2009 .03 SG1-SL 17 Corespondence and Memoranda: Administrative 3 FY 2013 2010 .06 SG1-SL 17 Corespondence and Memoranda: Administrative 3 FY 2014 2011 0.5 TOTAL CUBIC FEET THIS PAGE: ,I�