Records Disposal Certificate Form PDF Details

Handling documents and ensuring their proper disposal is a critical aspect of maintaining organizational accountability and compliance. The Records Disposal Certificate form serves as a vital tool in this process, providing a structured method for organizations, specifically within Illinois, to document the intent to dispose of records in line with the guidelines laid out by the Local Records Commission. Situated in the Margaret Cross Norton Building in Springfield, this certificate requires detail such as application number, agency division information, and the types of records for disposal, including their volume and retention dates. Before disposal, the form must be completed thoroughly, with all items listed in numerical order and record series titles matching those on the application. A noteworthy requirement is the advance submission of the certificate, at least sixty days prior to the intended disposal date, ensuring ample time for approval. Additionally, the certificate covers the authentication of records that have been microfilmed or digitized, verifying their reproduction and maintenance meets the strict standards of the Local Records Commissions’ regulations. Once the form is filled, signed, and sent to the designated address, entities must hold onto the records until they receive an approved copy of the certificate. This protocol underscores the importance of meticulous record-keeping and compliance with prescribed procedures for record disposal, reflecting an organization’s commitment to responsible information management and regulatory adherence.

QuestionAnswer
Form NameRecords Disposal Certificate Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesgarbage disposal certificate, certificate of disposal sample, certificate of disposal, used cooking oil disposal certificate template in south africa

Form Preview Example

RECORDSDISPOSALCERTIFICATE

APPLICATION #: _____________________________________

TO: Local Records Commission

Margaret Cross Norton Building

Springfield, IL62756

217-782-7075

DIRECTIONS:

COUNTY: _____________________________________

FROM: _____________________________________

(Agency Division)

ADDRESS: _____________________________________

(Street, P.O. Box)

1.Fill in all blanks and columns.

2.Application item numbers must be listed in numerical order.

3.Record series titles must be listed as they appear on application.

4.Sign and send certificate to above address sixty (60) days prior to disposal

5.Retain records until approved copy is returned.

6.This form can be found online at http://www.cyberdriveillinois.com/.

_____________________________________

(City, ZIP Code)

CONTACTTELEPHONE: (______)_______________________

date. CONTACT EMAIL: ____________________________________

APPLICATION

 

INCLUSIVE

VOLUME OF RECORDS

RECORD SERIES TITLE

DATES

ITEM NO.

(CU. FT. OR MB/GB)

(MONTH/YEAR)

 

 

 

 

 

 

 

 

 

 

 

 

Total Volume from all pages

Cu. Ft. _____

MB/GB _____

If any of the above records are microfilmed, I hereby certify that they have been reproduced in compliance with standards given in Sections 4000.50 and 4500.50 of the Regulations of the Local Records Commissions.

If the records are digitized, I certify that they have been repro- duced in compliance with standards given in Sections 4000.70 / 4500.70 and will be maintained in compliance with standards given in Sections 4000.80 / 4500.80 of the Regulations of the Local Records Commissions.

I hereby certify that, in compliance with authorization received from the Local Records Commission, the records listed above will be disposed of on or after:

Date

Approved by ILSOS

SignatureDate

Print name and title on line above

__________________________________

Prepared by:

(Signature required only if records have been microfilmed or digitized)

 

Printed by authority of the State of Illinois. December 2018 — 1M — LR 4.14

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