STATE OF OKLAHOMA 

ARCHIVES AND RECORDS COMMISSION

COVER SHEET

Records Disposition Schedule  __________

	

Amendment to Records Disposition Schedule  __________

Records Disposition Authorization		  __________	

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Name of Agency

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Date Approved by Archives and Records Commission	

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Name of Division

As required by OAC 60:10-3-2(b) of the Rules and Regulations of the Archives and Records Commission, the State Records Administrator must be notified thirty (30) days in advance of any destruction of records carried out in accordance with this Records Disposition Schedule/Records Disposition Authorization.  Notification shall be on submitted on one of the following forms:

•	ARC Form 4, (Notice of Intent to Destroy)
•	ARC Form 5 (Notice of Intent to Destroy Records That Have Been Microfilmed), accompanied by
•	ARC Form 5A, (Microform Quality Evaluation)
•	ARC Form 6 (Notice of Intent to Destroy Microforms),
•	ARC Form 12 (Notice of Intent to Destroy Records That Have Been Imaged),
•	ARC Form 13 (Notice of Intent to Destroy Optical Disks), or
•	ARC Form 14 (Notice of Intent to Delete Information From Rewritable Optical Disks)

Each form must list the Records Disposition Schedule/ Records Disposition Authorization Number, the names of the records series involved, inclusive dates, and the number of cubic feet, reels, or optical disks to be destroyed or the files to be deleted from rewritable optical disks.	

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Chairman

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Lieutenant Governor

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State Auditor and Inspector

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State Treasurer	

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Signature of Agency Head	

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State Librarian and State Records Administrator	

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Title	

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Date	
White  - Archives and Records Commission Copy
Green - Records Management Division Copy
Yellow - Agency Copy
Pink     - Secretary of State	ARC Form 1
Rev.   07/97