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Reproduce this farm as needed. <br />North Carolina. Department of Cultural Resauurces <br />Division of I~istorical Resources <br />Government Records Branch <br />REQUEST FOR DISPOSAL OF UNSCHEDULED RECORDS <br />'~q Assistant Records Administrator <br />N.C. Division of Historical Resources <br />Government Records Branch <br />4G15 Nail. Service Center <br />R.a~e~..ggh, NC 27G99~4G15 <br />FROM Name <br />County <br />,Agency or department <br />Phone number <br />ba accordance with the provisions of G.S. X21 and X32, approval is requested for the destruction of records listed below. These records , <br />have no further use or value for o~'ficial. or administrative purposes. ~ , <br />RECQ~.ns;T~rr~ I3ESCR~~oiv ~ Irtc~~sruE QuArr~ri~c` M~crco~n? ~ RETEU~r~oN <br />L1AZ`ES ;(YES OR Nd~ Peon '_" <br />. <br />Requested by: <br />Signature Title Date <br />Approved by. a <br />Signature Head of Governing Board Date <br />Concurred by: <br />~as ifldicated~ Signature Assistant Records Administrator Date <br />NC Division of Historical Resources <br />9~ <br />