REQUEST FOR AUTHORITY TO DISPOSE OF STATE RECORDS Texas State Library State and Local Records Management Division – RMD 102 (11/07) Refer to instructions on reverse before completing. RMD Control Number (RMD Use Only) Use typewriter or computer to complete this form. 1. Agency Name and Division 2. Agency Code 3. Date 4. Agency Mailing Address 5. Agency Individual to Receive Final, Approved Copy 6. Location of Records 7. Record Medium 8. Volume ft., MB, etc.) TSL State Records Center Other Under provision of Texas Government Code 441.035(3) Act of the 72nd Legislature, I hereby request permission to dispose of the following described state records which have no further legal, fiscal, administrative or historical use to this department for the reason indicated. 9. The records have fulfilled their retention requirements. 10. Microphotographic reproductions of the records, complying with the minimum standards established by the American National Standards Institute (ANSI), have been made and certified as original records for all legal purposes. The type and quality of the reproduction will fulfill the retention requirements of the original records. 10a. The records are essential (vital) records as defined by Texas Government Code 441.052, Act of the 70th Legislature. A preservation duplicate of the original micrographic reproduction has been made and preserved in compliance with this Statute. 10b. The records are non-essential and therefore a preservation duplicate is not required. 11. DESCRIPTION OF RECORDS Includes Records Series Titles, Records Series Numbers (if applicable). If records are in storage at the Texas State Library Records Center, included Locator Numbers, and Transfer Dates, or attach a copy of the Transmittal Forms (Tx-R-5 or RMD 101) to this form. FOR RECORD MANAGEMENT DIVISION USE ONLY APPROVALS 12. Records Management Officer 13. Director & Librarian 14. State Auditor (If Required, See Reverse) Date: Date: Date: Reproduction of this form at the agency level is authorized.
REQUEST FOR AUTHORITY TO DISPOSE OF STATE RECORDS Texas State Library – State and Local Records Management Division RMD 102 (11/07) Refer to instructions on reverse before completing. Use typewriter or computer to complete this form. RMD Control Number (RMD Use Only) 1. Agency Name and Division 2. Agency Code 3. Date 4. Agency Mailing Address 5. Agency Individual to Receive Final, Approved Copy 6. Location of Records TSL State Records Center Other 7. Record Medium 8. Volume ft., MB, etc.) Under provision of Texas Government Code 441.035(3) Act of the 72nd Legislature, I hereby request permission to dispose of the following described state records which have no further legal, fiscal, administrative or historical use to this department for the reason indicated. 9. The records have fulfilled their retention requirements. 10. Microphotographic reproductions of the records, complying with the minimum standards established by the American National Standards Institute (ANSI), have been made and certified as original records for all legal purposes. The type and quality of the reproduction will fulfill the retention requirements of the original records. 10a. The records are essential (vital) records as defined by Texas Government Code 441.052, Act of the 70th Legislature. A preservation duplicate of the original micrographic reproduction has been made and preserved in compliance with this Statute. 10b. The records are non-essential and therefore a preservation duplicate is not required. 11. DESCRIPTION OF RECORDS Includes Records Series Titles, Records Series Numbers (if applicable). If records are in storage at the Texas State Library Records Center, included Locator Numbers, and Transfer Dates, or attach a copy of the Transmittal Forms (Tx-R-5 or RMD 101) to this form. FOR RECORD MANAGEMENT DIVISION USE ONLY APPROVALS 12. Records Management Officer 13. Director & Librarian 14. State Auditor (If Required, See Reverse) Date: Date: Date: Reproduction of this form at the agency level is authorized.
rmd102.docx