HomeMy WebLinkAboutDisposition Forms_29-17_10/13/2017_Clerk RECORDS DISPOSITION DOCUMENT No. 21-17
Revised : 4/6/12 PAGE 1 OF 1 PAGES
1.AGENCY 2.DEPARTMENT 3.BUREAU
Village of Tequesta Village Clerk's Office 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.SUBMITTED BY:1 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 S are to be disposed of in the
litigatli°n pending or imminent manner checked below(specify only one):
Signature Date �. Destruction Q b.Microfilming and Destruction
ELI a.1 Shred ® a.2
Recycle
Q c. imaging and Destruction
Lori McWilliams, Village Clerk
Name and Title Q d. Other
a LIST of PrtD SEMES
a. b. C. d. e. f. 9-
Schedule Item Title Retention Inclusive Volume Disposition
Item No. Dates in Action and Date
Cubic Completed After
Feet Authorization
GS1-SL 146 Transitory Messages- Clerk's Office osA 8t2011-12/2013 .10 rya tI
GS1-SL 3 Admin. Support Records/Russell oSA 1982-2013 .05
White Disks ����11�
TOTAL CUBIC FEET: .15
S. 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)
c
Signature: nt �L— Date: �d(�'31 i n Signature: b� Date: 10 �j ill
Print Name: Lori McWilliams Print Name:
Print Tile: Village Clerk Print Title:
NOTE:Upon disposition retain this form for your records