HomeMy WebLinkAboutHUMAN RESOURCES 11/24/2021 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) Agency Records
D
Description ate Method of
Records Series Records Retention Retention
DAN Records Series Title Minimum Retention Period (13ox/Item numbers, Dates Covered Destruction(See
DAN Scheduleion
examples below*)
volume,etc) Met
Employee GS50-05A-26 Employment Retain for 3 years after 70 documents 1/1/2018— 12/31/2019 12/31/20 Secure shredding
Development, Rev. 2 Eligibility date of hire or 1 year after
Performance and Verification—U.S. separation from agency,
Work History Citizenship and whichever is later then
Immigration Destroy.
Services (USCIS)
*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 bedestroyed.
The individual responsible for inventorying the listed records must sign below prior to the Record's Manager approval: / n ,, AP-ILLWr,t0
c/n' /nEmployee Signatur Printed Nam ( 11 i( Division: LL?3aJ 13 QE2l/,r[i5
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Records Manager Signature: ' /6rif4`-1&//,-- / Printed Name: l(0 t Date Approved: if/ rDC
The person/people responsible for the destruction of records must sign upon destruction/of the listed records: /�
•
Employee Signatur • Printed Names L/1 t� K.t iV 1 l�Ci{/�/ I 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"Retain for the life of the agency"pursuant to CORE series GS50-09-06.
Form Revised 05/06/2014