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107 <br /> �!��0 NC DEPARTMENT OF GOVERNMENT RECORDS SECTION <br /> ■NEE NATURAL AND CULTURAL RESOURCES STATE RECORDS CENTER <br /> ■ ONE <br /> ncdcr.gov 4615 • .•' . • .•11 <br /> Request for Disposal of Original Records Duplicated by Electronic Means <br /> If you have questions, call(919) 814-6900 and ask for a Records Management Analyst. <br /> This form is used to request approval from the Department of Natural and Cultural Resources to dispose of non-permanent <br /> paper records that have been scanned, entered into databases, or otherwise duplicated through digital imaging or other <br /> conversion to a digital environment.This form does not apply to records that have been microfilmed or photocopied or to <br /> records with a permanent retention. <br /> Agency Contact Name: Date (MM-DD-vYYY): <br /> Phone (area code): E-mail: <br /> County/Municipality: Office: <br /> Mailing address: <br /> i <br /> Records Series Title Description of Records Inclusive Approx.Volume Retention <br /> A group of records as listed Specific records as referred Dates of Records Period <br /> in records retention to in-office (1987-1989; (e.g."l file As listed in records <br /> schedule 2005- resent) cabinet,""5 boxes") retention schedule <br /> f <br /> Requested by: <br /> Signature Title Date <br /> Approved by: <br /> Signature Requestor's Supervisor Date <br /> Concurred by: <br /> Signature Assistant Records Administrator Date <br /> State Archives of North Carolina <br /> A-21 <br /> i <br /> I <br />