Records Management Forms

There are two separate forms (Destruction Form and Disposition Log) that are required and must be completed with all departmental signatures and then submitted for review by the University Records Officer prior to the disposition of any records, with the exception of records that are determined to be Convenience Copies. If a record is being sent to the archives for preservation, then it is necessary only to record this on the Disposition Log.

PVAMU Records Destruction Form

Instructions for completing the Destruction Form

  1. Enter the Department Name, Date, Location and Phone Ext.
  2. Select the Destruction Method. (Shredding for paper documents or Electronic Destruction for records stored in a document management system).
  3. Select the Agency Item Number from the drop-down menu.
  4. Enter the Date Range (MM/YYYY). These dates are inclusive and should be for the oldest to the most recent dates of the documents. (Ex. If you have documents from January 20, 1990 to September 8, 2000, you would enter the date range as 01/1990 – 09/2000).
  5. Select the Medium, which would be paper or electronic.
  6. Departmental Records Coordinator must sign and date the form.
  7. Department Head must sign and date the form.
  8. At the time of disposition the department records coordinator must have a witness sign and date the form in which they will be attesting to the fact that they were present and saw the records being disposed of.
  9. The University Records Officer will sign and date the destruction form and leave a copy of the form with the department. The University Records Officer will maintain the original copy of the form according to the state retention schedule.

PVAMU Records Disposition Log

Instructions for completing the Disposition Log

  1. Enter the Department Name.
  2. Enter the name of the Records Coordinator (This is the individual in your department that is responsible for handling records).
  3. Select the correct Agency Item Number from the drop-down menu.
  4. Enter the beginning and ending dates of the records.
  5. Indicate the appropriate method of final disposition, (A – Archive), (S- Shred). All confidential records must be cross shredded or otherwise rendered unreadable.
  6. Enter the Box Number.
  7. Enter the disposition date (This date should be at or past the retention period of the record).
  8. Department Head must sign and date the form. Department Head must sign prior to any records being disposed of.
  9. Keep the original completed records disposition log in the department and forward a copy to the University Records Officer

PVAMU Records Coordinator Form

Each department has to designate one individual and a backup, that will be responsible for handling records within their respective department. The individual will be the point of contact when any questions regarding their department’s records arises and will be the point of contact for the University Records Management Officer.