Records Disposition Form Page 2

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DISPOSITION LOG
RMD 101A Date Issued 4/1/97, Revised 10/3/2009
PRINT OR TYPE
Record Series Title
Container
Record Series
Retention
Please review Records Retention Schedule
Dates of Records
Disposition Date
Number
Item No.
Period
Drop Down Box Provides for Record Series Title
FOR RECORDS
Received By
Date Received
( )Approved by Authority of SLR 105 & SLR
Final Disposition
Final Disposition Date
RMD Job Number
Method
105C signed - Date
MANAGEMENT
( )Approved by RMD 102
DIVISION USE ONLY
Date

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