Records Management
Instructions for Completing the Disposition Request Form
Blocks 1 -3. Administration/College, Department/Office, Unit/Program - Identify the organization and the appropriate element having responsibility for the records.
Examples:
- Administration/College - Administrative Affairs
- Department/Office - Finance & Accounting
- Unit/Program - Property
Block 4. Address. Enter the address of the office submitting the form (use your campus box number). This is the address to which the request will be returned after review.
Block 5. Contact. Indicate the name and telephone number of the person immediately responsible for the maintenance and security of the records. This is the person to whom inquiries regarding the records will be directed.
Block 6. Submitted by. The signature, title, and date of an authorized person is required before the request will be processed.
Block 7. Records Management, General Counsel & Archival Review. For Records Management, General Counsel and Archives use only.
Block 8. Notice of Intention. Indicate the disposition method to be used for the records listed in Block 9.
Block 9. List of Record Series. It is here that you should identify each of the record series that you are seeking disposition approval.
1. In column (a.) you should identify the schedule number, GS1, for example.
2. In column (b.) you should identify the item number, in this case #2.
If the record series you are listing is a duplicate, place the letter b. after the item number (example, 2b).
If there is no letter following the item number, it will be assumed that the record series you are listing is the record copy.
3. In column (c.) you should identify and list the exact title of the records that correspond to the schedule and item number(s) you listed in columns (a. and b.). In this case, Administrative Convenience Records.
Please use the title(s) indicated in the General Schedule you are using. This will prevent confusion during the approval process.
4. Column (d.) is for Records Management Use Only.
5. In column (e.) you should identify the date range of the records that you would like disposition approval on. Example, (01/01/91 - 12/31/93).
6. In column (f.) you should identify the number of cubic feet occupied by the records. For help in determining these numbers see VIII. Records Volume Conversion to Cubic Foot Measurements.
7. In column (g.) indicate the disposition action taken and the date completed, example, recycled 7/2/1999. This column is completed only after the form has been approved and returned to the requestor.
Block 10. Disposal Authorization. For Records Management Use Only.
Block 11. Disposal Certificate. This block requires the signature and title of the custodian or designee of the records along with that of a witness, indicating that the destruction or other disposition for the listed record series has been completed as indicated in column (g.). TO BE COMPLETED AFTER DISPOSITION REQUEST HAS BEEN APPROVED.
