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Records destruction request form

Are you authorized to submit this form for your department?

Before submitting this on-line form, you must have the authorization of your department head to submit Certificates of Records Destruction. If you are not authorized, complete the Appointment of records coordinator (PDF | 73KB) form. Once the form has been processed, you may submit the form below.

Once you are authorized to submit this form for your department, please fill in all fields, then click "Send Request." A confirmation of your request will be sent to the email address provided. A 10 item check list of Shredding Guidelines will be sent to you with your labels. If you have questions or problems please contact Records Management.

Records Management Services will approve and send you a hard copy of your request. If any of the records are to be shredded, you will also receive a destruction label for each of the corresponding boxes of records. Please refrain from using boxes larger than a copy paper or standard banker box.

Records sent to us for shredding must be cleaned of paper clips, black metal clips, carbon, and plastic material. Manila folders should be pulled. If the folders have sensitive data on them and need shredding, please send them separately from their contents.

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Certificate of records disposal instructions

Information on Records Coordinator

*Note: All automated responses will use this address.

This form documents the destruction of public records in accordance with the Virginia Public Records Act, ' 42.1-86.1 of the Code of Virginia.

Records to be destroyed
 

Add more rows

Records
Series
Number
Record titleDate range
FROM
Date range
TO
Number of
boxes
Shred? (default is recycle)
1:

Public records may NOT be destroyed without receiving prior approval from the University Records Manager.

I certify that the records listed above have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist.


Yes   No