Records Retention STATE OF FLORIDA
D~P~m~T o~ STATE I RECORDS RETENTION
Division of Library and laformation Services [
Form LSSEIOSREff. 1-01 m SCHEDULE / New ~chedule
I
Revise Existing
| -- -- Schedule
General Information
1. Agency
4. Custodian (Name & Area Code/Telephone Number)
2. Division/Department . I 3. Bureau/Office -.
5. Contact/R~LO (Name & Area Code/Telephone Number)
SUBMIT TO:
Florida Department of State
Bureau of Archives and Records Management
Mail Station 9A
Tallahassee, FL 32399-0250
Agency:
Address:
AGENCY MAH JNG ADDRESS:
City, State, Zip:
Record Series Information
6. Record Series Title
7.
General Description, Purpose and Use of Record Series (include/attach inclusive dates, any audit
requirements, forms, or other related documentation)
Record Copy and/or __ Duplicate, if duplicate please indicate location of the record copy in the description.
8. Is this record series considered to be a vital record? Yes No
What is the primary purpose of this record series?
Administrative __ Legal
Fiscal
What media format does this record series consist of?. Check all that apply. __ Paper Microfilm
__ Electronic (Magnetic D/sk, Optical Image, CD} DVD, etc,)'
__ Other (Audio, Video, Photographic, etc.)
Recommended Retention and Disposition
What is the'recommended retention period? Record Copy Duplicate Copies
Applicable Statutes, Rules, Ordinances .
Will this record series be microfilmed? Yes No
Will this record series be scanned into an optical imaging system? __
Yes No
Il0. Submitted by:
~uutho~ ~e, Title
Authorization.
Date
RECORDS DISPOSITION DOCUMENT NO.
Revised 04/2001 · · P~,GE 1 OF I PAGES
1. AGENCY 2. D/VZSION 3. BUREAU
The City of Sunshine -Administration
4. AD~)RESS (Stree~ City, and Zip Code) 5. CONTACT (Name and Telephone Number)
1001 Sunshine Drive Suzie C. Clerk
Sunshine, Florida 33330 ~ - 555-555-1111
6. SUBt4TrrED BY: I hereby certify that the records to be 7. NOTTCE OF INTENTTON
disposed of are correctly r,epresented below; that any audit
requirements for the records have'been fully justified, and that -The scheduled records listed in Item 8 are to be disposed of in the
further retention is not required for any litigation pending or manner checked below (specify only one):
imminent.
X a. Destruction b. Hicrofilming and Destruction
Signature Date
c. Other
Name and Title
8. LZST OF RECORD SERIES
a. b. c. d. e, f. g.
Schedule Item ' Title RetenUon Inclusive Volume Disposition
Item No. Dates in_ Action and
Cubic Date
Feet Completed
Alter
* Authorization
GSI'L 17a Correspondence and Memoranda: 3 FA 10/01/1993- 10
Administrative 09] 30/1998
(Note:
O
State (Note: State
will-use ~ use the State
the GS1- fiscal Years'
s) ....
07/01/1993-
06/3011998)
o
·
SAMPLE DISPOSITION
· FORM
9. DISPOSAL AUTHORIZATZON Disposal for the above listed 10. DTSPOSAL CER1/I;~CATE The above listed records have been
records is authorized. Any deletions or modifications are disposed of in the manner and on the date shown in column g.
indicated.
Signature Date
Name and Title
02/15/2002
Records Custodian or Designee Date
Witness
NOTE: Upon disposition retain this form for your records.