HomeMy WebLinkAboutDispositions Forms_07-23_7/6/2023_Human Resources—
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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, 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. red atDepartmen�tLevel, O c. Send to Storage until O e. Recycle
Disposition Date Met
b. Send to Storage for Shredding O d. Remove from Server O f. Other
;These
paper documents are saved electr ically.
. SUBMITTED BY (Department Head/S nor Staff Member Only):
I ereby certify that the records to be di osed of are correctly represented below, that any audit requirements for the
re rds h ve en f ly justified, a at further retention is not required for any litigation pending or imminent.
' Merlene Reid, HR Director
/fikzh- 22
Signa e u 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
GS1-SL
162
Personnel Records
50 FY
1998-2018
1.5
S rr
GS1-SL
162
Personnel Records
50 FY
2019-2020
1.5
GS1-SL
162
Personnel Records
50 FY
1979-2017
1.5
TOTAL CUBIC FEET THIS PAGE:
4.5
6. DISPOSAL AUTHORIZATION: Disposal for
7. DISPOSAL CERTIFICATE: The above listed records have been
e above listed records is authorized. Any
disposed of in the manner and on the date shown in column g.
eletionss/o'rQmodifications are indicated.
q4w,
41"G M
Clerk's Office Signature Date
S ure of Person Disposing of Records Name/Title ate
Routi
n :
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
OR
Form Updated: 9/21/21