Request 575 - City Clerk/Special Master RECORDS DISPOSITION DOCUMENT .o. sTs
Revised 04/2001, PAGE 1, OF 1. PAGES
1,. AGENCY 2. DZVZSZON 3. BUREAU
CZTY OF MZAM! BEACH CZTY CLERK SPEC~.AL MASTER
4. ADDRESS (Street, City, and Zip Code) 5. CONTACT (Name and Telephone N~iii~er)
1,700 CONVENTZON CENTER DRZVE LZSA R. MARTZNEZ (305) 673-71,81,
MZAM! BEACH, FLORZDA 331,39
6. SUBMTI'rED BY: ! hereby cerUfy that the records to be 7. NOY~CE OF ZNTENTZON
disposed of are correctly represented below, that any audit
requirements for the records have been fully justified, and that The scheduled records listed in Ztem 8 are to be disposed of in the
further re~tion is not require~ for ar)y litigation pending or manner checked below (specify only one):
immine
~B~'~ /~ /~/ff-,4/~ ~-- / X a. Destruction b..icrofilmingandDestruddon
Sig~ll~tu~e (~ Date
i T_~ R. HARTZNEZ, CLERK OF T~IE SPE~Z~AL HASTER c. Other
N · and Ti
a. b. c. d. e. f. g.
Schedule Item liUe Retention Indusive ¥olume
Item No. Dat~ in
(.RE C,SES) A.ER
/
9. DZSPOSAL AUTHORZZAT[ON Disposal for the above listed 1,0. DZSPOSAJ. CER ~ ,r~CATE The above ;;~.~d records have ~-cc.~
records is authorized. Any deletions or modifications are disposed.et~ the .manner and or,the date shown in columr)tg.
indicated. Si - tu~re~ //~ ~]/t ~'-.~(,._) ~h:>'~'Da,
! T~. R. MAR'rZNEZ~ C.[~RK OF THE SPECZAL MASTER
I Na~l~/and Titl4/ /
Records Custodian or Designee Date ~itness~ 1 --
NOTE: Upon disposition retain bqis form for your records.