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228 <br /> ■ ■■■ GOVERNMENT RECORDS SECTION <br /> ■■ NC DEPARTMENT OF STATE RECORDS CENTER <br /> ■E".3 NATURAL AND CULTURAL RESOURCES <br /> ■ i■■ <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-YYYY): <br /> Phone (area code): Email: <br /> County/Municipality: Office: <br /> Mailing address: <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. "1 file As listed in records <br /> schedule 2005- resent) cabinet,""5 boxes") retention schedule <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-21 <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. 2769941615 State Courier 51-81-20 Raleigh,N.C. 27601-2823 <br />