Quantity of Retention Records Records (# of Category of Record Description of Records Date - Date - Period as per contain Destruction Method # of linear From To the Records *PI? feet, # of Retention electronic (Y/N) Schedule records) Name of Approving Officer: __________________________________Title: _________________________Signature: _________________________ Records Destroyed by (name): Destroyed: ____________________________________
Category of Record Description of Records Date - From Date - To Retention Period as per the Records Retention Schedule Quantity of Records (# of # of linear feet, # of electronic records) Records contain *PI? (Y/N) Destruction Method Name of Approving Officer: __________________________________Title: _________________________Signature: _________________________ Records Destroyed by (name): Destroyed: ____________________________________