Archive Storage Request

Archive Storage Request

Prepare one form for each box. Do not fill a box with records having different destruction dates.

Box Number year / Department / Phone # / HR Code
of
Prepared by (Name) / Date Prepared
Dates Covered / Record Series / Total Retention Period (in years) / Destruction Date (Month/Year)
From / Through

·  Keep a copy for your records and put the completed original form in the box. The original request will be returned with the Archive Location Number indicated. All future references to these records must include location number.

·  Label outside of box with HR code, date of destruction and box numbers in permanent marker on the end of the archive box. See example

·  Submit a work request to have boxes moved to the archives.