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Certificate of Records Destruction
Consult the retention and disposal guidelines established by the state of Alabama to complete this form.
Match the records you propose to destroy with the appropriate description in the retention and disposal
guidelines. Select the appropriate Record Title from the retention and disposal guidelines. Select the
appropriate Retention Period from the retention and disposal guidelines.
The retention and disposal guidelines apply only to the record copy of a document. You can destroy duplicate
copies when they outlive their usefulness to your department. Estimate the volume of material you propose
to destroy in cubic feet.
Complete this form at least 72 hours prior to the scheduled pick-up or shredding day. Send the completed form
for approval to John Varner in Special Collections at the Ralph Brown Draughon Library. Fax to 334-844-1704
or mail to his attention.
Do not destroy records until the form has been returned to you with the Special Collections Signature line
complete. Include a copy of the signed form with the documents on the scheduled pick-up or shredding day.
Contact John Varner
at 334-844-1732 with any questions regarding this form and/or records destruction.
Department: ________________________________________________________
Contact: ____________________________________________________________
Phone: _____________________________________________________________
Fax: _______________________________________________________________
Email: _____________________________________________________________
Record Title: ________________________________________________________
Inclusive Dates: _____________________________________________________
Number of Boxes: ____________________________________________________
Retention Period: ____________________________________________________
Department Signature and Date: ________________________________________
Department Account Number: __________________________________________
Special Collections Signature and Date: ___________________________________
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Those who say it can not be done, should not interrupt those doing it. | Chinese Proverb