HomeMy WebLinkAboutDisposition Forms_26-16_12/28/2016_Police �
. - � � - . . � . No. �.�,— � c�
Revised : 1/22/14 PAGE OF PAGES
1.AGENCY 2.DEPARTMENT POIICG 3.BUREAU
Village of Tequesta N/A
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.SUBMIITED 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):
On/y the Dep nt Head as the authoriry to sign off on Item 6.
Shred
Signature �' Date 10/24/2016
Name Christopher L.Elg
Title Chief of Police
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
GS2 4 Alarm and Emergency Contact Records Until Obsolete 111/2011 -12/31/2011 .10 S�Y� ��-I��
GS2 4 larm and Emergency Contact Records Until Obsolete 5/1/2012-7/31/2012 .5
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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 col g.
(Witness to the Records Dis osition)
� Ull d�I � .�''" Date
Signature � Im��. Date Signature
Print Name: Lori McWilliams,MMC Print Name Brad Gom
Print Title: Village Clerk Print Title IT Director `�____
NOTE:U on dis osition �in this form for our r rds
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