HomeMy WebLinkAboutDisposition Forms_47-15_06/30/2015_Clerk • ' ' • • • NO. 47 -15
Revised: 1/22/14 PAGE OF PAGES
1. AGENCY 2. DEPARTMENT Clerk 3. BUREAU
Village of Tequesta I NSA LeISLr`fPChed
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 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):
Only the Department Head has the authority to sign off on Item 6.
Recycle
Signature Date 07 -28 -2015
Name Lori McWilliams
Title Clerk
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
Co p; �S , -or��t na lS i m�j-ed Cubic Completed After
Feet Authorization
GS1 -SL 32 Agenda Backup (plans) Copies Perm 2001, 2015 -15 .25
GS1 -SL 353 Land Development and Planning (Teq. Drive Bridge) Perm 2009 .37
9. DISPOSAL AUTHORIZATION: Disposal for the above listed records 10. DISPOSAL CERTIFICATE The above listed records have been
authorized. An deletions or modifications are indicated disposed of in the manner and on the date shown in column g.
(�' 7
(Witness to the Records Disposition)
Signature '"�`� '� Date -7 1 �� Signature Date 07 -29 -2015
Print Name: Lori McWilliams, MMC Print Name Deanna Mayo
Print Title: Village Clerk Print Title Assistant to Clerk
NOTE: UDon disposition retain this form for your records
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