Request for Authority to Destroy

REQUEST FOR AUTHORITY TO DESTROY

UNSCHEDULED/SCHEDULED RECORDS

(updated 12/23/08)

Department:

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Date:

Department Head Approval:

Certifications: (Check Appropriate Block):

I hereby certify that the records to be disposed of are correctly listed on the reverse side and that there destruction will be carried out in accordance with Local Government Code §202.003.

I hereby certify that the records listed below have been microfilmed in strict accordance with Local Government Code, Chapter 204, and the rules adopted under it. The destruction of the original records will be carried out in accordance with Local Government Code §202.003 and the microfilm copy will be maintained as the original records.

Name and Title:

Signature:

/ /

Date:

LIST FILES ON ATTACHED PAGE(S)

This section to be filled out by City Secretary Only.
The destruction of the records listed on the back of this page is Approved.
The destruction of the records listed on the back of this page is NOT APPROVED for reasons stated in the attached letter.
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Date:

Sylvia R. Trevino, City Secretary

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/

By:

Destruction Date

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City of Harlingen Records for Destruction
(This page to be attached to Request for Authority to Destroy Unscheduled/Scheduled Records)
Department: / Box No.
Division or Function:

The Retention Series Number and Retention Period information MUST be filled in for each entry. This information can be found in the Texas State Library Local Schedules EL, GR, HR, LC, PS, PW or UT.

*If applicable, codes to be used: AV - As long as administratively valuable, CE - Calendar year end, CFR – Code of Federal Regulations, FE - Fiscal year end, TAC – Texas Administrative Code, US – Until Superseded.

Record Title & Description / Inclusive Dates / Retention
Series
Number / Retention Period
(# of years and/or codes*)