HomeMy WebLinkAboutCITY CLERK - 04/20/2016 (3) 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 fiN 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(COREJ).
- Legal Disposition Authority(taken from Records Retentlon Schedule) Agenty Records
Descriptlon Date Method of
Records Series Tftle Records Serles Records Retention Minimum Retentlon Perlod (Box/Item numbers, Dates Covered Mtnimum Destruction(See
DAN Schedule volume,etc.) ReMet�n examplesbelow')
Pubiic:Notice GS2012-016 CORE 3.1 6 years after notice Affidavit of 10/9/2006& il/21/2006 11/21/12 Secure Recycling
(Official) Rev.0 published or event Publications '
*Examples of inethods ojdestruction:electronic deletion,in-house OR outside contractor shredding,secure recycling,other(describeJ
Stotement: The public records listed above have met their minimum reteniion period(s), are not subject to ongoing or reasonably anticipated litigation or
publlc records requests, are not needed for audit or other agency business, and shall be destroyed.
The individual responsible for invent ing the listed records must sign below prior to the Record's Manager approval:
Employee Signature: , Printed Name: Shannon L.Corin Division: Citv Clerk/Finance
The Records Manager must sign approval of this request prior to the destruction of the listed records:
Records Manager Signature. ` Printed Name: Shannon L.Corin Date Approved: �������
The person/people resp 'ble for the destruction of r�cords must sign upon destruction of the listed records:
' ��zv� /�
Employee Signature: Printed Name: Shannon L.Corin Date Records Destroyed:
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'ftetain for the life of the agency"pursuant to CORE series G550-09-06.
Form Revised 05/06/2014