CoSA - Forms used by State Archives and Records Management Programs

Forms Used by
State Archives and Records Management Programs
Updated April 7, 2007

Florida	Publications & Forms for Records Managers http://dlis.dos.state.fl.us/recordsmgmt/publications.cfm Records Storage Transmittal Forms http://dlis.dos.state.fl.us/recordsmgmt/publications.cfm Records Retention Schedule Records Disposition Document Transmittal and Receipt for Records Storage Request for Reference Service Request for Return of Reference Service Work Records Storage Box Labels Request for Non-SRC Records Disposal - Request for Non-SRC Destruction and Non-SRC Destruction Box Label Records Inventory Worksheet Transmittal/Receipt Transfer of Public Records to the Florida State Archives Publications and Forms for State Archives http://dlis.dos.state.fl.us/barm/pubforms.html Form 105 - Records Retention Schedule (WORD Version) (ACROBAT Version) Records Disposition Document (WORD Version) Form 201 & 202 - Transmittal and Receipt for Records Storage (WORD Version) (ACROBAT Version) Form 203 - Request for Reference Service (WORD Version) (ACROBAT Version) Form 206 - Request for Return of Reference Service Work (WORD Version) (ACROBAT Version) Form 807 - Transmittal/Receipt Transfer of Public Records to the Florida State Archives (WORD Version) (ACROBAT Version) Records Storage Box Labels (2 per page or 3 per page)Instructions for preparing boxes for transfer Request for Non-SRC Records Disposal - NonSRC Request Form and NonSRC Label Records Inventory Worksheet (WORD Version) (ACROBAT Version) Deed of Gift (WORD Version) (ACROBAT Version)
Illinois	State Records Disposal Certificate http://www.cyberdriveillinois.com/departments/archives/records_management/srmdisp.html State Records Center Transfer Sheet http://www.cyberdriveillinois.com/departments/archives/records_management/srctrans.html#transfer State Records Transfer Sheet http://www.cyberdriveillinois.com/departments/archives/records_management/srectran.html State Records Security Microfilm Transfer Sheet http://www.cyberdriveillinois.com/departments/archives/records_management/smictran.html Local Records Disposal Certificate http://www.cyberdriveillinois.com/departments/archives/records_management/lrmdisp.html
Louisiana	Record Transmittal and Receipt Form http://www.sec.state.la.us/archives/records/F-AR103.PDF Request for Authority to Dispose of Records http://www.sec.state.la.us/archives/records/F-AR930.PDF
Massachusetts	State Agency Forms http://www.sec.state.ma.us/arc/arcrmu/rmurds/rdssaf.htm RCB-1E: Application for Systems Information Management Plan. RCB-2: Application for Destruction Permission. RCB-2T: Application for Transfer Permission RCB-4: Records Liaison Officer Designation
Michigan	Records Forms for Local Government Offices http://www.michigan.gov/hal/0,1607,7-160-17445_19273_21738-113205--,00.html Record Series Inventory (HAL 507) Electronic Records Series Inventory (HAL 270) Local Government Records Retention and Disposal Schedule (MH-43) Local Government Certificate of Records Disposal (MH-38) State Archives of Michigan Direct Records Transmittal (MH-85) State Records Center Records Transfer Request (HAL 2112)
Minnesota	Application for the Disposal of (PR-1) and Transfer of Records http://www.mnhs.org/preserve/records/recser.html#forms
North Carolina	Government Records Branch Forms http://www.ah.dcr.state.nc.us/records/forms.htm
South Carolina	Record Center Transmittal form http://www.state.sc.us/scdah/techlflt.htm#forms
Utah	Online Forms http://www.archives.state.ut.us/main/index.php?module=Pagesetter&func=viewpub&tid=1&pid=206
Virginia	Online records management forms http://www.lva.lib.va.us/whatwedo/records/forms/index.htm

Questions or concerns? Contact CoSA at info@statearchivists.org.
Last updated: April 7, 2007 .