HomeMy WebLinkAboutDisposition Forms_27-13_08/14/2013 RECORDS DISPOSITION DOCUMENT NO. '2 , —1
Revised 11/9/07 PAGE t OF 1 PAGES
1.AGENCY 2. DEPARTMENT 3.13UREAU
Village of Tequesta N/A
4. ADDRESS (Street, City, and Zip Code) 5. CONTACT (Name and Telephone Number)
345 Tequesta Drive Lori McWilliams, CIVIC
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):
Signature Date K:::]a. Destruction 0 b. Microfilming and Destr
® a.1 Shred LJ a.2 Recycle
c. Imaging and Destruction
Name and Title LLI 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
109 UNIFORM CRIME REPORTS (UCR) obsolete 2003 -2012 .25
superseded,
or j
administrative
GS2 value is lost
Sh Redd
9. DISPOSAL AUTHORIZATION: Disposal for the above listed records 10. DISPOSAL CERTIFICATE The above listed records have been
authorized. Any d etions or modifications are indicated disposed of in the manner and on the date shown in column g.
(Witness to the Records Disposition)
Signature: Date: (7� Signature: Date:
V '3 ( ► r3
Print Name: Lor McWilliams Print ame: 6 0!i
Print Title: Village Clerk Print Title: c o m yN 1U Y'fr 0 15
`` >n 1 NOTE: Upon disposition retain this form for your records
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