HomeMy WebLinkAboutDispositions Forms_31-23_7/6/2023_Finance01110"W
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).
0 a. Shred at Department Level c. Send to Storage until e. Recycle
Disposition Date Met
0 b. Send to Storage for Shredding d. Removed from Server f. Other
4. SUBMITTED BY:
I hereby certify th a recor to be disposed of are correctly represented below, that any audit requirements for the
records have bee ly, , i , and that further retention is not required for any litigation pending or imminent.
Chris Quirk 08/22/18
Signa ta re Name and Title (Senior Staff only) Date
-911111,4111111
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
GS14
113
Utility Customer Records
3 FY
10/1/16 - 9/30/17
4
3
TOTAL
CUBIC FEET THIS PAGE:
4
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.
deletions or modifications are indicated.
Records Liaison Officer Signature Date
Signature Name/Title Date
ANNE Routing:
WE
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 storage
Originating deprtcnen# t dispose and document column g,
then sendsj�%''
at the storage room and will contact Public Works to remove
records
;- Completed form tofitage Clerk's Office for permanent
3. Clerk's Office will be responsible for final disposition of
rett
recor t.
a Form Updated 4111/18
