HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Library & Cultural Arts; 2021-01-21This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2019
Page | 1
DATE: 11/23/2020
REQUESTING DEPARTMENT: LIBRARY LEARNING CENTER REQUESTER: CARRIE SCOTT
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
DEPARTMENT HEAD DATE RECORDS MANAGEMENT DATE CITY ATTORNEY DATE
*If 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 once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: ___________________________
CERTIFICATE OF DESTRUCTION? YES NO
TAB BARCODES DELETED BY: _____ ________________________ DATE: _________
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD TAB BARCODE (if applicable)
1 box LITERACY LEARNER RECORDS/
STUDENT RECORDS 2015 LIB-075 Inactive/ Separation +5 years N/A
1 box Library Volunteers / Unpaid Intern Applications & Agreements - Successful 2017 LIB-070 Inactive /
Separation + 3 years N/A
RECORDS DESTRUCTION AUTHORIZATION FORM
Suzanne N. Smithson 11/30/2020 11-30-2020 12/1/2020
Corodata DATE: _____1/21/2021_________
N/A
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