Orange County NC Website
Browse       Search
Reproduce this form as needed. <br />North Carolina Department of Cultural Resources <br />Division of Historical Resources <br />Government Records Branch <br />REQUEST FOR CHANGE IN RECORDS SCHEDULE <br />TO Assistant Records Aduunistrator <br />N.C. Division of Historical Resources <br />Government Records Branch <br />4615 Mail Service Center <br />Raleigh, NC 27699-4615 <br />FROM Name <br />County <br />Agency or department <br />Phone <br />INSTRUCTIONS <br />Use this form to request a change in the records retention and disposition schedule governing the records of pour agenry. <br />Submit the signed original, and keep a copy for your file. A proposed amendment will be prepared and submitted to the <br />appropriate state and local officials fox their approval and signature. Copies of the signed amendment will be sent to you for <br />insertion in your copy of the schedule. <br />CHANGE REQUESTED <br />Add a new item <br />Delete an existing item Standard Number Page Item Number <br />Change an retention period Standard Number Page Item Number <br />TITLE OF RECORDS SERIES IN SCHEDULE OR PROPOSED TITLE <br />INCLUSIVE DATES OF RECORDS <br />VOLUME OF RECORDS IN LINEAR INCHES <br />DESCRIPTION OF RECORDS <br />PROPOSED RETENTION PERIOD <br />Requested by: <br />Signature <br />Title <br />Date <br />92 <br />