Revised: 11/03/2010
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Texas A&M University-Kingsville
RECORDS DESTRUCTION FORM
Department
Contact Person
Number of Containers
Date
Office Address
Telephone
Description of Records &
Records Retention Agency Item Number
Retention
Period
Medium
Departmental Certification/Request for Destruction
We certify that these state records are past the retention period specified by The Texas A&M University System Records
Retention Schedule and that all audit and administrative requirements have been satisfied.
CAUTION: A state record may not be destroyed if any litigation, claim, negotiation, audit, open records request, administrative
review, or other action involving the record is initiated before the expiration of the retention period. The record must be retained until
completion of the action and the resolution of all issues that arise from it, or until the expiration of the retention period, whichever is
later. Texas Government Code §441.187(b). Any record subject to federal audit must be retained until the expiration of the audit
period or the period specified in the Systems Records Retention schedule, whichever is later.
_______________________________________________________________ _________________________
Department Head Signature Date
Required Approval
Departmental Destruction
_______________________________________ ________________
Registrar Signature Date
Date of Records Destruction
Destruction Method
_____ Shredding
_____ Electronic
Witness Signature & Date:
Certificate of Destruction Attached
Note: Once destruction of documents has been
completed, a copy of this form needs to be submitted
to the Office of the Registrar, TAMUK.