Laserfiche WebLink
Reproduce this form as needed. <br />North Carolina Department of Cultural Resources <br />Division of Archives and Records <br />Government Records Section <br />REQUEST FOR DISPOSAL OF UNSCHEDULED RECORDS <br />TO Assistant Records Administrator <br />N.C. Division of Archives and Records <br />Government Records Section <br />4615 Mail Service Center <br />Raleigh, NC 27699 -4615 <br />FROM Name <br />Countv <br />Agency or department <br />Phone number <br />In accordance with the provisions of G.S. 121 and 132, approval is requested for the destruction of records listed below. These <br />records have no further use or value for official or administrative purposes. <br />RECORDSTITLE DESCRIPTION INCLUSIVE DATES QUANTITY MICROFILMED? RETENTION <br />(YES OR NO) PERIOD <br />Requested by: <br />Approved by: <br />Concurred by: <br />(as indicated) <br />Signature <br />Title <br />Date <br />Signature Head of Governing Board Date <br />Signature Assistant Records Administrator Date <br />NC Division of Archives and Records <br />117 Attachment number 1 <br />G -3 Page 171 <br />