HomeMy WebLinkAboutLEGAL - 02/18/2014 (2) Local Government Public Records Destruction Log
The purpose of this form Is to document compliance and reasonable accountability by verifying that specific public records have met current, approved minimum
retention periods before being destroyed pursuant to RCW 40 14 070, WAC 434 - 610 -070, and WAC 434 - 640 -010, -020, and -030 Please fill out this form when
destroying all public records whose minimum retention is other than "Retain until no longer needed for agency business then destroy" (such as records covered in
the "Records with Minimal Retention Value" section of the Local Government Common Records Retention Schedule (CORE)
Legal Disposition Authority (taken from Records Retention Schedule) Agency Records
Description Agency
Method(s) of
Records Series Records Series Records Retention Minimum Retention Period (Box/item numbers, Dates Covered Minimum Destruction
Title DAN Schedule Retention (See examples,
volume, etc j Met below*)
Claim for GS50 -01- 6 years 6 years from claim closed 1 bankers Closed 2007 12/31/13 secure recycling for
outside contractor
Damages 10 Rev 1 box shredding
*Examples of methods of destruction electronic deletion, in -house OR outside contractor shredding, secure recycling, other (describe)
Statement: The public records listed above have met their minimum retention period(s), are not subject to ongoing or reasonably
anticipated litigation or public records requests, are not needed for audit or other agency business, and shall be destroyed.
The Individual responsible for Inventorying th ted records must sign below prior to the Records Manager's approval
Employee Signature k,. 'rated Name Thelma Swem Division City Attorney Offi
The Records Manager must sI approva I equest-prior to the destruction of the listed records
Records Manager Signature Printed Name Shannon C onn Date Approved 2/18/14
The person /people responsible for #ie dest==Name sign upon destruction of the listed records
Employee Signature Thelma Swem Date Records Destroyed 2/18/14
Vendor Business Name (if used) Phone
Vendor Signature Printed Name Date Records Destroyed
The retention and disposition action for this Public Records Destruction Log is "Retain for the life of the agency" pursuant to CORE series G550 -09 -06
This sample form was prepared by Washington State Archives as a courtesy to local government agencies In January, 2014
It may be modified to meet individual agency needs