HomeMy WebLinkAboutDispositions Forms_27-16_10/2/2019_Finance (2) RECORDS DISPOSITION DOCUMENT NO. all- I Lt
Revised : 4/6/12 PAGE 1 OF 1 PAGES
1. AGENCY 2. DEPARTMENT 3. BUREAU
Village of Tequesta Finance N/A
4.ADDRESS (Street, City, and Zip Code) 5.CONTACT(Name and Telephone Number)
345 Tequesta Drive Lori McWilliams, MMC
Tequesta, FL 33469 561-768-0440
6. SUBMITTED BY: I hereby certify that the records to be disposed of are 7. NOTICE OF INTENTION
correctly represented below,that any audit requirements for the records
have been justified,and that further retention is not required for any The scheduled records listed in Item 8 are to be disposed of in the
litigati g or immi nt. manner checked below(specify only one):
Signat re Date a. Destruction 0 b. Microfilming and Destruction
y __1 a.1 Shred Da.2 Recycle
JoAn F rsythe, Fiance Director 66 c. Imaging and Destruction
Name and Title d. Other
8.LIST OF RECORD SERIES
a. b. C. d. e. f. g.
Schedule Item Title Retention Inclusive Volume Disposition
Item No. Dates in Action and Date
Cubic Completed After
Feet Authorization
GS1-SL 195 Payroll Records: Supporting Docs. 5FYS FY2012 3
GS1-SL 340 Disbursement Records: Detail 5 FYS FY2012 1.5
c0 b1 1
TOTAL CUBIC FEET:
9. DISPOSAL AUTHORIZATION: Disposal for the above listed records 10. DISPOSAL CERTIFICATE The above listed records have been
authorized.Any deletions or modifications are indicated disposed of in the manner and on the date shown in column g.
(Witness to the Records Disposition)
Signature: Date. Signature: �j Date: lb '
Print Name: Lori McWilliams Print Name:
Print Title: Village Clerk Print Title:
NOTE: Upon disposition retain this form for your records
emended: 2/8/16