GSA Form SF-115 "Request for Records Disposition Authority"

What Is GSA Form SF-115?

This is a legal form that was released by the U.S. General Services Administration on March 1, 1991 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 1991;
  • The latest available edition released by the U.S. General Services Administration;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;

Download a fillable version of GSA Form SF-115 by clicking the link below or browse more documents and templates provided by the U.S. General Services Administration.

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Download GSA Form SF-115 "Request for Records Disposition Authority"

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Request for Records Disposition Authority
Leave Blank (NARA Use Only)
(See Instructions on reverse)
Job Number
To: National Archives and Records Administration (NIR)
Washington, DC 20408
Date Received
1. From: (Agency or establishment)
Notification to Agency
2. Major Subdivision
In accordance with the provisions of 44 U.S.C.
3303a, the disposition request, including
amendments, is approved except for items that
3. Minor Subdivision
may be marked "disposition not approved" or
"withdrawn" in column 10.
4. Name of Person with whom to confer
5. Telephone (include area code)
Date
Archivist of the United States
Agency Certification
6.
I hereby certify that I am authorized to act for this agency in matters pertaining to the disposition of its records and that the records proposed
for disposal on the attached
page(s) are not now needed for the business of this agency or will not be needed after the retention
periods specified; and that written concurrence from the General Accounting Office, under the provisions of Title 8 of the GAO Manual for
Guidance of Federal Agencies:
is not required
is attached
has been requested
Signature of Agency Representative
Title
Date (mm/dd/yyyy)
9. GRS or
7. Item
10. Action taken
8. Description of Item and Proposed Disposition
Superseded Job
Number
(NARA Use Only)
Citation
115-109
NSN 7540-00-634-4064
Standard Form 115 (Rev.3/91)
Page
of
Previous Edition Not Usable
Prescribed by NARA 36 CFR 1228
Request for Records Disposition Authority
Leave Blank (NARA Use Only)
(See Instructions on reverse)
Job Number
To: National Archives and Records Administration (NIR)
Washington, DC 20408
Date Received
1. From: (Agency or establishment)
Notification to Agency
2. Major Subdivision
In accordance with the provisions of 44 U.S.C.
3303a, the disposition request, including
amendments, is approved except for items that
3. Minor Subdivision
may be marked "disposition not approved" or
"withdrawn" in column 10.
4. Name of Person with whom to confer
5. Telephone (include area code)
Date
Archivist of the United States
Agency Certification
6.
I hereby certify that I am authorized to act for this agency in matters pertaining to the disposition of its records and that the records proposed
for disposal on the attached
page(s) are not now needed for the business of this agency or will not be needed after the retention
periods specified; and that written concurrence from the General Accounting Office, under the provisions of Title 8 of the GAO Manual for
Guidance of Federal Agencies:
is not required
is attached
has been requested
Signature of Agency Representative
Title
Date (mm/dd/yyyy)
9. GRS or
7. Item
10. Action taken
8. Description of Item and Proposed Disposition
Superseded Job
Number
(NARA Use Only)
Citation
115-109
NSN 7540-00-634-4064
Standard Form 115 (Rev.3/91)
Page
of
Previous Edition Not Usable
Prescribed by NARA 36 CFR 1228