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CERTIFICATE OF RECORDS DESTRUCTION

  1. Are/Were the records eligible for destruction in accordance with the Town's Retention Schedule (Texas State Library & Archives Commission-TSLAC)?*

    If no or not sure, contact the Records Mgmt Coor/Deputy Town Secretary or review the Retention Schedule.

  2. Have the records already been destroyed?*

  3. 1ST ENTRY

  4. This is the title of the records as defined by TSLAC

  5. This is the Record Number as defined by TSLAC (i.e. GR1000-3d)

  6. 2ND ENTRY

  7. 3RD ENTRY

  8. 4TH ENTRY

  9. 5TH ENTRY

  10. 6TH ENTRY

  11. Name of supervisor or dept. head that authorized the destruction of records.

  12. Do you have space limitations where you are unable to store the records until the Town-wide destruction day?*

  13. This information would be used to generate a facilities request to have the records transferred to records storage.

  14. Leave This Blank:

  15. This field is not part of the form submission.