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A DIVISION OF THE ARIZONA SECRETARY OF STATE (Arizona State Library, Arhives and Public Records)

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Page 1 of 6
PART 1: REQUEST FOR APPROVAL
A.
1.
The format of the official records will be: Paper Microfilm
2.
3.
Phone: (602) 926-3815 • FAX: (602) 256-2838 • E-Mail: records@azlibrary.gov
Revised 10/2019 An Equal Opportunity Employer
RECORDS SCANNED FOR ACCESS OR WEB DISSEMINATION ONLY
The Applicant will retain the official records only for the period specified on a records schedule
approved by LAPR, and will suspend scheduled destruction of any record potentially responsive to
reasonably foreseeable litigation, audit, or investigation.
The Applicant may destroy copies of the records before, but not retain longer than, the approved
retention period.
The agency [here after referred to as "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 scan records described on the
attached list and agrees to comply with the following conditions and standards:
See Attached list of record series to be imaged.
REFER TO THE MINIMUM STADARDS FOR DIGITAL IMAGING OR SCANNING OF TEXTUAL
DOCUMENTS BEFORE COMPLETING THIS FORM. CHECK ALL OF THE CATEGORIES THAT APPLY
IN PART 1 AND INITIAL ALL BOXES IN PART 2 OF THIS FORM.
Records for web dissimination only may be scanned at 150 dpi bitonal or higher. The Applicant
recognzes that the scanned web dissemination copy is not the official record, and will retain the official
record for the period specified on a records schedule approved by LAPR. Certified copies must be
made from the official record.
Polly Rosenbaum State Archives and History Building
1901 W. Madison St. • Phoenix, Arizona 85009 • Home Page: http://www.azlibrary.gov/records
SUBMISSION DATE:
EXPIRATION DATE:
Agency or Political
Subdivision Title:
ARIZONA STATE
LIBRARY, ARCHIVES AND PUBLIC RECORDS
A DIVISION OF THE ARIZONA SECRETARY OF STATE
REQUEST FOR DOCUMENT IMAGING 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.
Page 2 of 6
ARIZONA STATE
LIBRARY, ARCHIVES AND PUBLIC RECORDS
A DIVISION OF THE ARIZONA SECRETARY OF STATE
REQUEST FOR DOCUMENT IMAGING OF PUBLIC RECORDS
4.
Applicant initials
5.
GIF PNG JPEG
TIFF v6
4
PDF
2
PDF/A
3
JPG2000
6.
200 dpi grayscale
300
7.
8.
9.
B.
1.
The format of the official records will be: Paper Digital Microfilm
2.
3.
4.
TIFF v6
1 or 4
PDF
2
PDF/A
3
JPG2000
5.
200 dpi grayscale
300
6.
7.
8.
Records will be scanned into the following file format(s):
Records will be scanned at the following minimum scan resolution:
IMAGING SYSTEM HAS ABILITY TO COMPLETELY
PURGE/DESTROY/EXPUNGE OBSOLETE RECORDS (IMAGES)
OPEN SYSTEM ARCHITECTURE
NON PROPRIETARY HARDWARE AND SOFTWARE
IMAGING SYSTEM HAS ABILITY TO COMPLETELY
PURGE/DESTROY/EXPUNGE OBSOLETE RECORDS (IMAGES)
OPEN SYSTEM ARCHITECTURE
Polly Rosenbaum State Archives and History Building
1901 W. Madison St. • Phoenix, Arizona 85009 • Home Page: http://www.azlibrary.gov/records
Phone: (602) 926-3815 • FAX: (602) 256-2838 • E-Mail: records@azlibrary.gov
An Equal Opportunity Employer
dpi 24-bit Color
200 dpi Bitonal
200 dpi Bitonal
NON PROPRIETARY HARDWARE AND SOFTWARE
Records will be scanned at the following minimum scan resolution:
150 dpi Bitonal
TOTAL RETENTION THIRTY YEARS OR UNDER
Records will be scanned into the following file format(s):
For Permanent Records Only: Per ARS 41-151.15 a. All records are the property of this state. The
official paper or microfilm record shall be kept by the Applicant or transferred to the State Archives for
permanent retention.
The applicant recognizes that permanent records covered by this request meet or exceed the state
standards per ARS 39.101.
The Applicant may destroy copies of the records before, but not retain longer than, the approved
retention period.
The Applicant will retain the official records only for the period specified on a records schedule
approved by LAPR, and will suspend scheduled destruction of any record potentially responsive to
reasonably foreseeable litigation, audit, or investigation.
dpi 24-bit Color
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Page 3 of 6
ARIZONA STATE
LIBRARY, ARCHIVES AND PUBLIC RECORDS
A DIVISION OF THE ARIZONA SECRETARY OF STATE
REQUEST FOR DOCUMENT IMAGING OF PUBLIC RECORDS
C.
1.
2.
3.
TIFF v6
1
PDF
2
PDF/A
3
4.
600 dpi grayscale
600
5.
6.
7.
PART 2: GENERAL REQUIREMENTS FOR ALL OPTIONS LISTED ABOVE
TOTAL RETENTION THIRTYONE YEARS OR LONGER (NOT PERMANENT)
The Applicant certifies that the images will use the most current versions of TIFF, JPG, or
PDF for the file format and that the images will conform to the minimum standards.
Applicant initials
400 dpi Bitonal
dpi 24-bit Color
Records will be scanned into the following file format(s):
Records will be scanned at the following minimum scan resolution:
Due to the long term retention of these records please identify and attach a copy of the study performed
in the justification of the chosen imaging process:
For state agencies only: The Applicant has submitted a Project Investment Justification (PIJ) to the
Arizona Department of Administration/Arizona Strategic Enterprise Technology (ASET).
The Applicant certifies that a migration/exit plan has been developed and will be followed for
all records approved under this request.
Applicant initials
The Applicant certifies that the digital images will be appropriately indexed for retrieval and
retention period based on key data elements in the records (date, name of parties to the
records, and other information specific to the particular records series).
Applicant initials
IMAGING SYSTEM HAS ABILITY TO COMPLETELY
PURGE/DESTROY/EXPUNGE OBSOLETE RECORDS (IMAGES)
OPEN SYSTEM ARCHITECTURE
NON PROPRIETARY HARDWARE AND SOFTWARE
Applicant initials all below
The Applicant has read the Minimum Standards for Digital Imaging or Scanning Textual
Documents and recognizes that the scanned records covered by this request meet or exceed
the minimum standards.
Applicant initials
Polly Rosenbaum State Archives and History Building
1901 W. Madison St. • Phoenix, Arizona 85009 • Home Page: http://www.azlibrary.gov/records
Phone: (602) 926-3815 • FAX: (602) 256-2838 • E-Mail: records@azlibrary.gov
Revised 10/2019 An Equal Opportunity Employer
The Applicant will institute a quality control process that includes inspecting at least 20% of
all records to ensure that all information on the scanned version is legible.
Applicant initials
The Applicant certifies that the benefits of digitizing these records justifies the costs and is
ready to demonstrate that to any concerned party.
Applicant initials
The Applicant has attached the list of record series to be imaged.
Applicant initials
Due to costs and long term commitment of information technology resources, the Applicant
certifies they have discussed this scanning project with the CIO/CTO/ IT director, or
equivalent, within your agency.
Applicant initials
Yes No
Yes No
Yes No
Yes No
Feasibility
Cost/Benefit PIJ (for State Agencies only)
Page 4 of 6
ARIZONA STATE
LIBRARY, ARCHIVES AND PUBLIC RECORDS
A DIVISION OF THE ARIZONA SECRETARY OF STATE
REQUEST FOR DOCUMENT IMAGING OF PUBLIC RECORDS
PART 3: AUTHORIZATION
REQUESTOR:
AUTHORIZED BY:
D
ate Approved
Dr. Dennis Preisler, State Archivist
R
ecords Analyst (or designee) Date Approved
Records Management Center
Signature:
Date:
Phone:
E-Mail:
Agency or Political
Subdivision Title:
Name (type or print):
Title: Records Officer or Designee (type or print):
Phone: (602) 926-3815 • FAX: (602) 256-2838 • E-Mail: records@azlibrary.gov
Revised 10/2019 An Equal Opportunity Employer
ACTION AUTHORIZED
As authorized under ARS §41-151.16, the Arizona State Library, Archives and Public Records authorizes the Applicant to
reproduce these records using electronic media following these procedures for a period of five years. Failure to comply
with these procedures is a violation of ARS §41-151.16.
Polly Rosenbaum State Archives and History Building
1901 W. Madison St. • Phoenix, Arizona 85009 • Home Page: http://www.azlibrary.gov/records
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Page 5 of 6
ARIZONA STATE
LIBRARY, ARCHIVES AND PUBLIC RECORDS
A DIVISION OF THE ARIZONA SECRETARY OF STATE
REQUEST FOR DOCUMENT IMAGING OF PUBLIC RECORDS
ATTACHMENT: RECORD SERIES TO BE IMAGED
Record Series Title as Stated on Approved Schedule
Schedule Number or
Date
Item #
Polly Rosenbaum State Archives and History Building
1901 W. Madison St. • Phoenix, Arizona 85009 • Home Page: http://www.azlibrary.gov/records
Phone: (602) 926-3815 • FAX: (602) 256-2838 • E-Mail: records@azlibrary.gov
Revised 10/2019 An Equal Opportunity Employer
Page 6 of 6
ARIZONA STATE
LIBRARY, ARCHIVES AND PUBLIC RECORDS
A DIVISION OF THE ARIZONA SECRETARY OF STATE
REQUEST FOR DOCUMENT IMAGING OF PUBLIC RECORDS
1.
2.
3.
1.
1.
1.
2.
3.
1901 W. Madison St. • Phoenix, Arizona 85009 • Home Page: http://www.azlibrary.gov/records
Phone: (602) 926-3815 • FAX: (602) 256-2838 • E-Mail: records@azlibrary.gov
Revised 10/2019 An Equal Opportunity Employer
Fill in the contact information for the requestor seeking approval.
ATTACHMENT: RECORDS SERIES TO BE IMAGED
List the Record Series title(s) associated with this imaging request using the exact record series name(s)
found on the approved Retention Schedule(s) being followed.
Enter either the schedule number or approved date for the Retention Schedule for each record series title.
Enter the item number for the record series title from the schedule for each record series title.
Polly Rosenbaum State Archives and History Building
The Minimum Standards for Digital Imaging or Scanning Textual Documents may be found on the State
Library, Archives and Records Management website at:
https://azlibrary.gov/arm/guidance-standards-and-statutes
Check all applicable boxes for A, B and C and initial where required.
PART 2: GENERAL REQUIREMENTS FOR ALL OPTIONS LISTED ABOVE
Initial all boxes for Applicant initials to indicate you have read the general requirements.
PART 3: AUTHORIZATION
INSTRUCTIONS
PART 1: REQUEST FOR APPROVAL
In the top section enter the name of your Agency or Political Subdivision and include any subdivision
breakdown for division, department or unit.
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Completed 20 July 2020

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