ALL ITEMS ARE REQUIRED
Box 1. Type Christopher Newport University
Box 2. Type the name of your department
Box 3. Type your name
Box 4. Type Address (e.g. 1 Avenue of the Arts, Newport News, VA 23606)
Box 5. (a) Type your telephone number
Box 5. (b) Type your E-mail address
Box 6. (a) Type both the retention schedule and series number that apply to the records to be destroyed.
(e.g. GS 111-101063)
ENTER ONLY ONE SERIES NUMBER PER FORM ROW
Box 6. (b) Type the title of the record EXACTLY (tip: copy & paste it from the schedule to the form) as it appears on the Schedule.
(e.g. Academic Counseling: Group Files/Test Results)
Box 6. (c) Type the date of the records. (Month/Year - Month/Year)
(e.g. 1/2012-12/2013 not 2012-2013)
Box 6. (d) Type the location where the records are stored
Box 6. (e) Type the volume/cubic feet size or in bytes for electronic records.
(This is required. See the Volume Estimation Table)
Box 6. (f) Type the way you plan to destroy the records (burn, shred, etc.)
STOP! STOP! STOP! STOP!
Box 7. Email the form to the approving official for review (i.e. the department chair, department head, etc.).
The approving official must type their own name on this line after they ensure that no pending litigation, audits, or FOIA requests would require a legal hold placed on these records.
Box 8. Email the form to the designated records officer for review (Susan Barber, email@example.com)
The person destroying the records needs to fill in this section, then they need to email the form back to the records officer (Susan Barber (firstname.lastname@example.org)