Notification of the Destruction of University Records
Your Name:
Your Title:
Your Department:
Your Email:
Subject:
Notification of the Destruction of University Records

This is to certify that the following record series was, on this date, destroyed by me, in accordance with the approved records retention schedule of this unit.

*** Records containing personally identifiable information (i.e. names, ssn, grades, salaries...) must be shredded. ***

Record Series
Period Covered
Method of Destruction
Series #
mm/yyyy - mm/yyyy
 

 

If documenting the destruction of more than 10 record series, please submit a second form.

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