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ARCHIVES AND RECORDS MANAGEMENT Submission date:
Approval date: Expiration date: Microfilm Control #:
The applicant agrees that the microfilm copy meets or exceeds state standards per ARS §39.101.
The applicant will institute a quality control process that includes inspecting at least 20% of all records to
ensure that all information on the microfilmed versions are legible.
REFER TO THE APPLICABLE LAPR
BEFORE COMPLETING THIS FORM. CHECK ALL
OF THE CATEGORIES THAT APPLY IN PART 1 AND INITIAL ALL BOXES IN PART 2 OF THIS FORM.
The applicant recognizes that archival (permanent) records covered by this request are to be retained permanently,
and that the microfilm copy meets or exceeds the state standards per ARS §39.101.
The applicant recognizes that the microfilmed copy may become the official copy, and if the source records are to
be destroyed, 100% of the records will be verified to ensure that all the information on the microfilmed versions
LIBRARY, ARCHIVES AND PUBLIC RECORDS
A DIVISION OF THE ARIZONA DEPARTMENT OF STATE
REQUEST FOR MICROFILMING OF PUBLIC RECORDS
ARS §41-151.16 A. Each agency of this state or any of its political subdivisions may implement a program for the
production or reproduction by photography or other method of reproduction on film, microfiche, digital imaging or
other electronic media of records in its custody, whether obsolete or current, and classify, catalogue and index such
records for convenient reference. The agency, before the institution of any such program of production or
reproduction, shall obtain approval from the director of the types of records to be produced or reproduced and of the
methods of production, reproduction and storage and the equipment which the agency proposes to use in connection
with the production, reproduction and storage. Approval pursuant to this subsection is necessary for digitizing
programs but not for individual instances of digitization. On approval from the director, the source documents may be
destroyed, but only after an administrative audit and after safeguards are in place to protect the public records
pursuant to section 41-151.15, subsection A.
Agency or Political Subdivision Title:
(here after referred to as "Applicant")
The Applicant requests authorization from the Arizona State Library, Archives and Public Records [here after referred to as LAPR], in
accordance with ARS §41-151.16, to microfilm records described below and agrees to comply with the conditions and standards in
Record Series Title as Stated on Approved Schedule