Certificate of Records Destruction

Consult the retention and disposal guidelines established by the state of Alabama to complete this form.

Match the records you propose to destroy with the appropriate description in the retention and disposal guidelines.

Select the appropriate Record Title from the retention and disposal guidelines.

Select the appropriate Retention Period from the retention and disposal guidelines.

The retention and disposal guidelines apply only to the record copy of a document. You can destroy duplicate copies when they outlive their usefulness to your department.

Estimate the volume of material you propose to destroy in cubic feet.

At least 72 hours prior to the scheduled Document Shredding day, complete this form, including the Departmental Signature and Account number, and send it to John Varner for approval.  Either fax to 334-844-1704 or mail to Special Collections in the R. B. Draughon Library.

Do not destroy records until the form has been returned to you with the Special Collections Signature line complete.  Include a signed copy of the form with the documents on the shredding day.

If you have questions, please contact John Varner at 844-1732.

Department Name:_______________________________________________

Contact Person:_________________________________________________

Phone and Fax Numbers:__________________________________________

Record Title:____________________________________________________

Inclusive Dates:_________________________________________________

Number of Boxes:_______________________________________________

Retention Period:________________________________________________

Department Signature and Date:____________________________________

Department Account Number:______________________________________

Special Collections Signature and Date:______________________________

Last Updated: Mar 02, 2011
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