HomeMy WebLinkAboutMUNI COURT - 09/22/2015 � City of Bremerton 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 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 Records Retention Schedule(CORE)).
Legal Disposition Authority(taken from Records Retention Schedule) Agenty Records I
Date Method of
Description Minimum
Records Series Title Records Series Records Retention Mlnimum Retention Period (Box/Item numbers, Dates Covered Destruction(See
DAN Schedule volume,etc.) RetMeton examples below•)
Source Records- GS50-09-14 CORE 3.1 Verification of Successful DM52-06B-01 Closed July 21,2015-August 08-15-15 Secure shred bin
Images(Non- Rev. 1 Conversion 15, 2015 for outside
Archival) contractor
shredding
Uniform Notice of DM52-066- District& 3 years Closed May 1-July 31, 2012 7-31-15 Electronic Copy
Infraction,Court 01 Municipal Courts Deleted
Docket, &Case File Retention
Schedule-V6
Uniform Citation, DM52-06A- District& 3 years Closed May 1-August 31, 8-31-15 Secure shred bin
Complaint, Court 01 Municipal Courts 2012 for outside
Docket&Case File Retention contractor
Schedule-V6 shredding
Uniform Citation, DM52-06A- District& 3 years Closed Jan 1-June 30,2010 6-30-13 Secure shred bin
Complaint, Court 01 Municipal Courts for outside
Docket&Case File Retention ,�,, contractor
(DV Cases) Schedule-V6 shredding
*Examples of inethods of destruction:electronic de/etion,in-house OR outside contractor shredding,secure recycling,other(describeJ
Statement: The public records listed above have met their minimum retenrion period(s), are not subject to ongoing or reasonab/y anticipated litigation or
public records requests, are not needed for audit or other aqency business, and shall be destroyed.
The individual responsible for inventorying the listed records must sign below prior to the Record's Manager approval:
Employee Signature:��(,�) Printed Name:�a�l�n ��SOn Division: �Un i G�Gt.I COU1r-�
The Records Manager must sign �pproval of this r st prior to the destruction of th 'sted records: ,y�
Records Manager Signature: Printed Name: /`�� 1'/��� Date Approved: � �^-o`-'I��
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: ��13Y1��OY1 Printed Name: -+�a.�l)Yl N�� �1�) Date Records Destroyed: �' d�'��
Vendor Business Name(if used): Phone:
Form Revised OS/06/2014
� City of Bremerton Public Records Destruction log
� Vendor Signature: Printed Name: Date Records Destroyed:
The retention and disposition adion for this Public Records Destrudion Log is"Retain for the life of the agency"pursuant to CORE series GS50-09-06.
Form Revised 05/06/2014
' �C� MA� MO�IIG� CERTIFICATE OF DESTRUCTION
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E-Mail: lms@wcnx.org � . �
Name: CO OP MUNICIPAL COURT-BREMERTON Phone: 1-877-898-0112 � �
Address: 550 PARK AVE Fax: 1-360-486-2467 °'.�� , �o`�
Cit . BREMERTON 98337 �
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Phone: 360-473-5242 Account#: 2185-952778-705 Route Id: SN92
Request: RWAUTO Invoice Date: 9/22/2015 Invoice#: 1179095
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: Acct: 952778-705
Service Description Qty Rate AmOunt
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Customer Signature: Date: Time