HomeMy WebLinkAboutDispositions Forms_14-09_11/19/2009 RECORDS DISPOSITION DOCUMENT NO~ / r v
Revised 11/9/07 PAGE OF 1 PAGES
1. AGENCY
Village of Tequesta 2. DEPARTMENT 3. BUREAU
N/A
4. ADDRESS (Street, City, and Zip Code) /~~Cj 2 ~ 2~~9 5. CONTACT (Name and Telephone Number)
345 Tequesta Drive Lori McWilliams, CMC
Tequesta, FL 33469 VILLAGE CLERKS OFFI X561-575-6200 ext. 244
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 fully justified, and that further retention is not required for any The scheduled records listed in Item 8 are to be disposed of in the
litigation pending or imminent. manner checked below (specify only one):
Signature Da/te ~a. Destruction 0 b. Microfilming and Destr~
~ / ~/y~~~ Q a.1 Shred Q a.2 Recycle
l~//Iv/y `Q c. Imaging and Destruction I
Name and Title litl~LC /R ~, M G~iGtorv+ ~ cF. ~y 0 d. Other
8. LIST OF RECORD SERIES
a.
Schedule
Item b.
Item
No. c.
Title d.
Retention e.
Inclusive
Dates f.
Volume
in
Cubic
Feet g.
Disposition
Action and Date
Completed After
Authorization
G$2 129 Criminal Investigative Records: Degree of Crime
Unknown/No Charges Filed 4 years
Anniversary 2002 1.12 ~ ~ ~ " f ~
~ ~1 19~uCf
9. DISPOSAL AUTHORIZATION: Disposal for the above listed records
authorized. Any deletions or modifications are indicated 10. DISPOSAL CERTIFICATE The above listed records have been
disposed of in the manner and on the date shown in column g.
I,'Witness to the Records Disposition)
~/ ~
Signature: ~~ ~l ~~~ Date: D ~~~ L~"~ Signature: ~ , ~' ~ ~~ ~ ~ Date: ~ ~f ~~~ ~~•. .,
Print Name: Lori McWilliams Print Name:
Print Title: Village Clerk /~
Print Title: / "
NOTE: UDOn disposition retain this form for vour records