HomeMy WebLinkAboutRECORDS TRANSMITTAL FORMRECORDS TRANSMITTAL FORM
This form is a PDF file, which you must type your information into, sign and e-mail or send by inter-
office mail to the Records Management Department. In addition, a printed copy of this completed and
signed form must be placed on top of inside of records box before sending it over for storage.
To: RECORDS MANAGEMENT OFFICE
Date: # of Files ______ or 1 Box__
From: Signature ____________________________
Department
Title(s) of Records Enclosed
Inclusive Dates
From To
Alpha/Numeric Range
For Records Management Office Use Only:
Box Location: Row____ Shelf____ Box Number____ Retention Period:__________
Storage Location: Vault ____ Storage Room____ Destruction Date:__________
Accepted For Storage By: Approved by:
Records Management Clerk Date Records Management Officer Date
Revised TOS 7/17/2012