Orange County NC Website
Browse       Search
GOVERNMENT RI X:( SICTION <br /> fa of ^I . .. ` ....� ;A1,.()1,.C\ STATE REC( .R1)S CENTER <br /> umummmmmmmmmmfmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm <br /> coll <br /> Aim <br /> REQUEST FOR CHANGE IN RECORDS SCHEDULE <br /> TO Assistant Records Administrator <br /> Division of Archives and Records <br /> Government Records Section <br /> 4615 Mail Service Center <br /> Raleigh, NC 27699-4615 <br /> FROM Name <br /> County <br /> Agency or department <br /> Mailing address <br /> Phone or email <br /> INSTRUCTIONS <br /> Use this form to request a change in the records retention and disposition schedule governing the records of <br /> your agency. Submit the signed original, and keep a copy for your file. A proposed amendment will be <br /> prepared and submitted to the appropriate state and local officials for their approval and signature. Copies of <br /> the signed amendment will be sent to you for 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 APPROXIMATE VOLUME OF RECORDS <br /> DESCRIPTION OF RECORDS <br /> PROPOSED RETENTION PERIOD <br /> Requested by: <br /> Signature Title Date <br /> Physical Address: State Courier 51-81-20 <br /> 215 N Blount Street Facsimile(919)715-3627 <br /> Raleigh,N.C. 27601 records @ncdcr.gov <br />