HomeMy WebLinkAboutDispositions Forms_40-23_7/6/2023_Finance--
NO. C5 A3
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, CIVIC, (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).
0 a. Shred at Department Level 0 c. Send to Storage until Q e. Recycle
Disposition Date Met
Qb. Send to Storage for Shredding 0 d. Remove from Server 0 f. Other
4. SUBMITTED BY (Department Head/Senior Staff Member Only):
hereby certify that the records to be disposed of are correctly represented below, that any audit requirements for the
records have be f Ily ju tified, and that further retention is not required for any litigation pending or imminent.
q��M S-714 4r,� 'A - 2-
Signature Name an itle (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
435
FINANCIAL TRANSACTION RECORDS:
5 FY
05/2020 - 05/2011
1.5
5h�
DETAIL (Utility Billing Back-up Reports)
-7 a
GS1-SL5
435
FINANCIAL TRANSACTION RECORDS:
10 FY
07/1991-10/1994
1..2
DETAIL (Water Cash Receipt Reports)
GS1-SL
436
FINANCIAL TRANSACTION RECORDS:
10 FY
FY 1985, 1986, 1991,
1.5
SUMMARY (General Ledger Trial Balance
1992 & 1993
GS1-SL
436
FINANCIAL TRANSACTION RECORDS:
10 FY
1995-1999
1.5
SUMMARY (Bank Stmts, Invest
C•a.. 4 .. %A/ f) O..-.... .. ..
TOTAL CUBIC FEET THIS PAGE:
5.75
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.
dele ' ns or modifications are indicated.
Clerk's Office Signature Dat6
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 12. Village Clerk's Office authorizesdisposition and/or storage`
3: Originating department to dispose and document column g, j 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
1 OR