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227 <br /> MEMOS GOVERNMENT RECORDS SECTION <br /> ■ENE■ NC DEPARTMENT OF <br /> ■iiC NATURAL AND CULTURAL RESOURCES STATE RECORDS CENTER <br /> MANE■ <br /> ncdcr.gov 46 - • .'• • • .'11 <br /> Request for Disposal of Unscheduled Records <br /> AGENCY INFORMATION <br /> Requestor name <br /> Location and Agency[e.g., County/Municipality+ Department of Social Services] <br /> Phone and email <br /> Mailing Address <br /> In accordance with the provisions of N.C. Gen. Stat. § 121 and § 132, approval is requested for the destruction <br /> of records listed below. These records have no further use or value for official administrative, fiscal, historical, or <br /> legal purposes. <br /> RECORDS TITLE INCLUSIVE QUANTITY RELEVANT PROPOSED <br /> AND DESCRIPTION DATES STATUTORY RETENTION <br /> REGULATIONS PERIOD <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 /> DIVISION OF ARCHIVES AND RECORDS—GOVERNMENT RECORDS SECTION A-20 <br /> http://archives.ncdcr.gov <br /> MAILING ADDRESS: Telephone(919)814-6900 LOCATION_ <br /> 4615 Mail Service Center Facsimile(919)715-3627 215 N.Blount Street <br /> Raleigh,N.C_ 27600-4615 State Courier 51-81-20 Raleigh,N.C. 27601-2823 <br />