HomeMy WebLinkAboutDispositions Forms_16-09_11/19/2009 RECORDS DISPOSITION DOCUMENT NO~ / ' ~
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) AU 5. CONTACT (Name and Telephone Number)
345 Tequesta Drive 1/~LLAGE CLERKS OFF ri McWilliams, CMC
Tequesta, FL 33469 561-575-6200 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):
Signa~t~ure~
V ~/ '
Name and Title~(f~~,,~ /~( ~~oG[,o~
Date ~. Destrudion 0 b. Microfilming and Destn
/ap/9 0 a.1 Shred Q a.2 Recycle
0 c. Imaging and Destruction
~ ~ P~L~~ ~ 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
GS2 129 Criminal Investigative Records: Degree of Crime
Unknown/No Charges Filed 4 years
Anniversary 200Q 2001 .75 ~' ~ '~~ ~
1~t~y~L~r
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)
/~ ' 1
Signature: f 1ti ~~,~,~/,~1. Date: ~ ~'v `
Signature:. ~ y' Y ~ ~ , ~ Date: ((~~~ L~
1 /
Print Name: Lori McWilliams Print Name:
Print Title: Village Clerk Print Title: i ~ ~ '/~
NOTE: UDOn disaosition retain this form for vour records