Form Rc-3 Certificate Of Records Disposal - Ohio Historical Society Page 2

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Page

of _____

Ohio Historical Society

For State Archives - LGRP Use Only

State Archives of Ohio

Date Received:

Local Government Records Program

Date Reviewed:

800 E. 17

Avenue

Items requested for transfer:

YES

Columbus, Ohio 43211-2497

If YES, attach copy of transfer form

Date Received:

CERTIFICATE OF RECORDS DISPOSAL (RC-3) – Part 1

Date Reviewed:

Items requested for transfer:

YES

See instructions before completing this form. Must be submitted with PART 2

If YES, attach copy of transfer form

(local government entity)

(unit)

(contact person)

(telephone number)

(location of records)

(address)

(city)

(zip code)

(county)

(date mailed to LGRP)

I hereby certify that the records listed on this RC-3 and attachments are being disposed of according to the time periods stated on the approved Records

Retention Schedules (RC-2) listed below. No record will be knowingly disposed of which pertains to any pending legal case, claim, action or request. In

addition, microfilm created in place of any original record listed on this RC-3 will be stored according to ANSI Standards and all microfilm master negatives will

only be used to create use copies. It is a responsibility of the local government to ensure the preservation and accessibility of any records retained in

electronic format.

_____________________________________________________________________________________________________________________________

(signature of responsible official)

(title)

(telephone number)

To have this form returned to the Records Commission electronically, include an email address: _______________________________________________________________

Please Note: The State Archives retains RC-3 forms for seven years.

It is strongly recommended that the Records Commission retain a permanent copy of this form.

Form: SAO/LGRP-RC3 (part 1), Revised July 2011