HomeMy WebLinkAbout; ; Records Destruction Authorization Form-City Clerk; 2016-03-14RECORDS
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REQUESTING
DESTRUCTION
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DESTRUCTION AUTHORIZATION
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DATE: 12/30/2014
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FORM
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S. FREISINGER
DEPARTMENT: CITY CLERK REQUESTER:
APPROVALS:
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DEPARTME T EAD DATE RECORDS MANAGEMENT DAT TY ATTORNEY DATE
,
BOX NO.
RECORDS DESCRIPTION
DATED
RRS NO.
RRS
PERIOD
TAB BARCODE
(if applicable)
W-2014
Closed Claims Against the City
2005
2009
0745-20
CL+5
See attached
*1f more spaces are needed, click in the last box in right hand corner of table and hit "tab". This will create more fields in the table.
To be filled out
RECORD DESTRUCTION
CERTIFICATE
TAB BARCODES
once records have been
COMPLETED
OF DESTRUCTION?
DELETED BY:
destroyed. ,
BY: G'
DATE:
DATE: 3-/')`-" I ,
RI YES NO
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This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
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Revised: 4/8/2015
`% CARLSBAD a; ;- I 1
City of Carlsbad
All City Clerk - Filter Applied
Barcode
K0206039
K0206863
K0207095
K0207384
K0207426
First Name
CLAIMS, OPEN - AGAINST THE CITY
CLAIMS, OPEN - AGAINST THE CITY
CLAIMS, OPEN AGAINST THE CITY
CLAIMS, OPEN AGAINST THE CITY
CLAIMS, OPEN AGAINST THE CITY
Second Name
January - April
January - April
May -
Sept -December
Third Name
Fourth_Name
2005
2006
2007
2008
2008
File_Code Color
074520 Blue
074520 Blue
074520 Blue
074520 Blue
074520 Blue
Wednesday, April 08, 2015 4:13:14 PM - TAB FusionRMS Grid Print
pdown Page: 1
Shred- it
3801 Ocean Ranch Blvd
Suite 101
Oceanside CA
92056
Phone: 760- 598- 5700
SERVICE RE( k ) 1, I) SUMMARY
CERTIFICATE OF DESTRUCTION
PLEASE KEEP THIS FO It YOUR RECORDS
IIISISNOTANIN�ci1C�?;
Customer: 00118ti'.2
CITY OF CARLSBAD- I;I.l u11)SMANAGEMENT
5815 El. CA !WINO REAL
CARLSBAD CA 92008- 8801
Order #: 8022396527
Order Date: 03.14.2016
Service Type: ON- SITE PURGE
Contact.
Time In: 10:17 AM
Y ? �bVvnr�
Material Collected
BANKERS/ARCHIVE BOX
Total:
Customer Signature; PAT
CSR Signature: DAVID SCHULTZ
157
157
Shred- it is committed to the secure destruction of its customers'
confidential information. This certification will affirm that
Shred- it destroys the customer confidential material, pursuant to
ow- customers request and instructions.
The following services are NAID certified:
Hard Drive Destruction
Mobile Destruction
Offsite Destruction
The following services are not NAID certified:
Non- Paper Destruction