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Items 1 - 5 Requesting Agency Information –
Enter: name, address, telephone number, records retention
schedule
number; signature and title of the official initiating the
request; signature and title of the Custodian of Public
Records approving the request; signature of the Records Manager,
and the request date. Note: The Request
Approved By signature may not be the same as the Requested
By signature in Item 3.
Item
6 Archival Review – The signature of the State
or Local Archivist performing the Archival Review for the
records listed in the disposal request.
Item
7 Premature Records Disposal – Enter for disposal
of hardcopy records whose retentions have not yet
expired but were microfilmed, or imaged, or were deemed unsalvageable
due to a disaster.
Item
8 Comments – A field dedicated for associated
comments.
Item
9 Record Series Number - Enter the record series
number as it appears on the current records retention
schedule.
Item
10 Record Series Title - Enter the record series
title exactly as it appears on the current records retention
schedule. In cases where a record series does not appear on
a schedule, contact a Records Analyst at the
Division of Archives and Records Management.
Item
11 Records Retention Period - Enter the retention
periods for the expired record series exactly as it appears
on
the current records retention schedule. If no retention period
has been established, contact a Records Analyst
at the Division of Archives and Records Management.
Item
12 Inclusive Dates - Enter the From Month/Year dates
through the To Month/Year dates of the record series
slated for disposal.
Item
13 Dispose After – Enter the date the records
may be slated for disposal.
Item
14 Volume - Enter the volume in cubic feet for each
record series and provide a total volume at the bottom of
the
form. Note: one full letter or legal size file drawer contains
two cubic feet. Fractions should be
rounded up.
Item
15 Audit Authorization – The Auditor Signature
for the Requesting Agency, in block 15A and date block 15B,
for all County and Municipal fiscal records. This must be
signed before submission to the Division of
Archives and Records Management. State Agencies complete items
1 through 14 only for fiscal records.
Item
16 DARM Authorization (Division) - Blocks 16A through
16C are reserved for the Division of Archives and
Records Management.
Item
17 Disposition - Enter the manner in which the records
have been disposed in Item 17. In block 17A include the
signature of the official verifying the disposal and the verification
date in block 17B. NOTE: Return all four
(4) parts of the form intact, to the Division. The Follow-up
and Requesting Agency copies will be returned
to you with items 16A through 16C completed - a Signature
in block 16C indicates formal approval of the
disposition request. After disposal, return the Yellow, DARM
Follow-up copy to the Division, the Goldenrod,
Auditor copy to the Auditor, and retain the Pink, Requesting
Agency copy to complete the process. Please
include a self-addressed envelope for expedited service.
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