RECORDS MANAGEMENT
INSPECTION AND RECEIPT FORM INSTRUCTIONS
1. ACTION – check the appropriate box
INSPECTION ONLY – indicates that you will be inspecting records at the storage facility.
RETURN TO DEPARTMENT – indicates you request that records be returned to your
department.
2. RECORDS INFORMATION
RECORDS DESCRIPTION - Enter the description as it appears on storage transmittal
form. Enter additional descriptive information when only certain documents or files within
a box are being accessed.
ACCESSION NO. - Enter the accession number from the storage transmittal form.
BOX NO. - Enter the box number as indicated on storage transmittal form.
SHELF NO. - Enter the shelf number as listed on the storage transmittal form.
3. AUTHORIZATION
DEPARTMENT - Enter requesting department name.
AUTHORIZED BY - Signature of department representative who is authorizing the access
of the records i.e. supervisory personnel, office manager, director, etc.
DATE – date of request/signature.
The remainder of the information will be completed when the records are accessed/delivered, and (if
applicable) when records are returned to the center.