HomeMy WebLinkAboutDispositions Forms_15-09_11/19/2009 RECORDS DISPOSITION DOCUMENT NO~ / 5 ~ 9
Revised 11/9/07 PAGE ~ OF 1 PAGES
1. AGENCY
Village of Tequesta 2. DEPARTMENT RECEIVED 3. BUREAU
N/A
4. ADDRESS (Street, City, and Zip Code)
345 Tequesta Drive
Tequesta, FL 33469
6. SUBMITTED BY: 1 hereby certify that the records to be disposed of are
correctly represented below, that any audit requirements for the records
have been fully justified, and that further retention is not required for any
litigation pending or imminent.
Signa/tAure/
vV'
Name and Title ~~~ /)'j C~
`~vv ~ ~ 5. CONTACT (Name and Telephone Number)
VILLAGE CLERKS OFFICE Lori McWilliams, CMC
561-575-6200 ext. 244
7. NOTICE OF INTENTION
The scheduled records listed in Item 8 are to be disposed of in the
manner checked below (specify only one):
Date I C~]a. Destruction
g/~~9 0 a.1 Shred Q a.2 Recycle
0 c. Imaging and Destruction
~ I Q d. Other
0 b. Microfilming and Destr~
8. LIST OF RECORD SERIES
a.
Schedule
Item b.
Item
No. c.
Title d.
Retention e.
Inclusive
Dates f.
Volume
in g.
Disposition
Action and Date
Cubic
Feet Completed After
Authorization
GS2 25 Complainbincident Reports 4 years
Anniversary 2000 2001 1.12 S ~l `~~~
) ~ -g~~?g
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.
(1Nitness to the Records Disposition)
~ r~ ~
Signature: (~ ~~I )(;/ ~~ /~ Date: ~~ v`(~ ~
r
"_ Signature: ~! ; ~~~~ ~ ~~ ~,r , ~'~ ~ r, , ,, , Date: l ~ ~ ~~~~(~
~C-~, ~-C~d~~'
Print Name: Lori McWilliam
s Print Name:
Print Title: Village Clerk Print Title: ~ ~,~
NOTE: UDOn disoosdion retain this form for vour records