Laserfiche WebLink
Attachment 1 <br />Reproduce this form as needed. <br />North Carolina Department of Cultural Resources <br />Division of Historical Resources <br />Government Records Branch <br />REQUEST FOR DISPOSAL OF ORIGINAL RECORDS DUPLICATED BY ELECTRONIC MEANS <br />TO Assistant Records Administrator <br />N.C. Division of Historical Resources <br />Government Records Branch <br />4615 Mail Service Center <br />Raleigh, NC 27699 -4615 <br />FROM Name <br />Department /Agency <br />Phone number <br />Use this form to request an amendment to your programs schedule from the Department of Cultural Resources to dispose of paper <br />records you have scanned, entered into databases, or otherwise duplicated through digital imaging or other conversion to computer or <br />digital environments. This form does not apply to records which have been microfilmed or photocopied. In addition, this form does not <br />apply to records with a permanent retention or that are to be transferred to the State Archives. Records with a permanent retention or <br />which will come to the State Archives must have a paper or microfilm copy. A completed copy of the "Self- Warranty" form must be <br />attached. <br />RECORDSTITLE DESCRIPTION INCLUSIVE QUANTITY MICROFILMED? RETENTION <br />DATES (YES OR NO) PERIOD <br />Requested by: <br />Approved by: <br />Signature <br />Title <br />Signature <br />Concurred by: <br />(except as indicated) Signature <br />Date <br />Agency Unit or Branch Manager Date <br />Assistant Records Administrator Date <br />