INSTRUCTIONS FOR COMPLETING RECORDS DISPOSITION REPORT
NOTE: Complete sections 1-6 on the form per the following instructions.
1. DIVISION - Enter the division of the university that your department or office is within i.e.
ACADEMIC AFFAIRS, ADMINISTRATIVE AFFAIRS, STUDENT AFFAIRS, UNIVERSITY
ADVANCEMENT.
2. DEPARTMENT - Enter your department name.
3. CONTACT - Enter the name, extension and email address of the department person who is
immediately responsible for the maintenance and security of records. This is the person to whom
inquires regarding the disposition request will be directed.
4. SUBMITTED BY - This section must be signed and dated by the department head.
Print that person's name and title in the space below their signature and date.
5. NOTICE OF INTENTION - Enter an "X" (auto-check online) by the disposition requested. This will
most always be "destruction" (note: records that are approved for destruction are deposited by Records
Management staff in a paper bin and transported to a recycling vendor). Any other disposition should
be discussed with the University Records Management Liaison Officer (RMLO) prior to completing
the form and they will instruct you on what to enter in such case.
6. LIST OF RECORD SERIES - Complete the following information for each record series listed. You
will need to refer to the records schedule in the back of the University Records Management Manual
for a, b and c below.
a. Schedule No. - Enter the appropriate records schedule number. This will be either GS1 or GS5.
This information appears at the end of each records series in the records schedule.
b. Item No. - Enter the appropriate number and letter (a or b) of the record series. The item number
is shown beside the schedule number for each listing in the records schedule. The letter, "a" or "b"
indicates "record copy" or "duplicate" and appears by the retention for each. Enter the Item
number in this way i.e. 3(a), with the letter in parenthesis.
c. Title - Enter the title of the record series as listed in the records schedule.
d. Ret. - leave this space blank. This space will be completed by the UWF RMLO.
e. Inclusive Dates - Enter the dates covered by the records (the period they are "inclusive in"). Use
the same period designation (fiscal year, calendar year, etc.) referred to in the retention, or if the
retention does not indicate a particular designation then use whatever is appropriate to the way you
maintain the records (calendar year, fiscal year, etc.). You may list more than one period (year,
fiscal year, semester, etc.). However, you need only list the beginning and ending dates, i.e.
7/92-6/94 (this example indicates the records are inclusive within the 2 fiscal years 92/93 and
93/94 ).
f. Volume in Cubic Feet - Enter the approximate number of cubic feet. The conversion chart (page
A-8) in the UWF Records Management Manual will be helpful if you are unsure of this amount.
g. Disposition Action and Date - Leave this blank. The UWF RMLO will use this space to document
the disposition action and date.
T H E U N I V E R S I T Y O F W E S T F L O R I D A
RECORDS DISPOSITION REPORT
NO. ___________
1. DIVISION
2. DEPARTMENT
3. CONTACT _____________________
Ext Email
4. SUBMITTED BY:
I hereby certify that the records to be
disposed of are correctly represented below, that any audit
requirements have been fully justified, and that further retention is
not required for any litigation pending or imminent.
______________________________________________
Department Head
Signature Date
______________________________________________
Department Head
Name and Title (Printed)
5. NOTICE OF INTENTION
The scheduled records listed in item 6 are to be disposed of in the
manner checked below (specify only one):
______Destruction ______
Scanning and Destruction
______Other ___________________________________
6. LIST OF RECORD SERIES
a.
Sched.
No.
b.
Item
No.
c.
Title
d.
Ret.
e.
Inclusive
Dates
f.
Volume
Cubic ft.
g.
Disposition
Action and Date
7. RMLO REVIEW:
I have reviewed this disposal report and
any deletions or modifications are noted.
___________________________________________________
Signature Date
8. ARCHIVIST REVIEW:
I have reviewed this disposal report
and any records transferred to the UWF Archives are noted.
___________________________________________________
Signature Date
9. DISPOSAL AUTHORIZATION:
Disposal for the above
listed records is authorized.
___________________________________________________
Director of Business & Auxiliary Services Date
10. DISPOSAL CERTIFICATE:
The above listed records have
been disposed of in the manner and on the date as shown in
column g.
___________________________________________________
Records Management Liaison Officer Date
___________________________________________________
Witness