Form VSARA-28 Records Delivery Request (Rdr) for Agencies Making Their Own Delivery Arrangements - Vermont

Form VSARA-28 or the "Records Delivery Request (rdr) For Agencies Making Their Own Delivery Arrangements" is a form issued by the Vermont Secretary of State.

Download a PDF version of the Form VSARA-28 down below or find it on the Vermont Secretary of State Forms website.

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VSARA-28
Rev. 03/2018
Vermont State Archives and Records Administration
Office of the Secretary of State
1078 US RTE 2, Middlesex ● Montpelier, VT 05633-7701 ● Tel: (802) 828-3700 ● Fax: (802) 828-3710
RECORDS DELIVERY REQUEST (RDR)
For Agencies Making Their Own Delivery Arrangements
See the reverse side for important instructions.
Submit the first page of this form to the above address or by e-mail to
sos.recordscenter@vermont.gov
Records Officer or Liaison:
Date:
Agency/Department/Division/Office:
This completed RDR (Form VSARA-28) must accompany the records being delivered.
Expected Date of Delivery:
Delivery Person or Company:
Delivery Contact Phone Number:
Delivery Contact Address:
Delivery Contact E-mail:
New Records Being Transferred For Storage
(Individual box numbers or a range of box numbers.)
# New Boxes
Box Numbers:
# Boxes of Interfiles
(
i.e., new files to be merged into existing boxes)
Checked Out Records Being Returned To Storage
(Individual box numbers or a range of box numbers.)
# Returning
Box Numbers:
Boxes
# Boxes of Refiles
(i.e., files returning to the box in which they were originally stored)
This Box For Records Center Staff Use Only
SRC Staff
Quantity
Declined Boxes (list box numbers) & Reason For Decline
(TL: Not on Box Transfer List  BM: Not boxed/marked properly  NF: Not found for pickup)
Initials
Accepted
New Boxes
Boxes of
Interfiles
Returning
Boxes
Boxes of
Refiles
Boxes Delivered By:
Signature
Printed Name
Date Delivered
VSARA-28
Rev. 03/2018
Vermont State Archives and Records Administration
Office of the Secretary of State
1078 US RTE 2, Middlesex ● Montpelier, VT 05633-7701 ● Tel: (802) 828-3700 ● Fax: (802) 828-3710
RECORDS DELIVERY REQUEST (RDR)
For Agencies Making Their Own Delivery Arrangements
See the reverse side for important instructions.
Submit the first page of this form to the above address or by e-mail to
sos.recordscenter@vermont.gov
Records Officer or Liaison:
Date:
Agency/Department/Division/Office:
This completed RDR (Form VSARA-28) must accompany the records being delivered.
Expected Date of Delivery:
Delivery Person or Company:
Delivery Contact Phone Number:
Delivery Contact Address:
Delivery Contact E-mail:
New Records Being Transferred For Storage
(Individual box numbers or a range of box numbers.)
# New Boxes
Box Numbers:
# Boxes of Interfiles
(
i.e., new files to be merged into existing boxes)
Checked Out Records Being Returned To Storage
(Individual box numbers or a range of box numbers.)
# Returning
Box Numbers:
Boxes
# Boxes of Refiles
(i.e., files returning to the box in which they were originally stored)
This Box For Records Center Staff Use Only
SRC Staff
Quantity
Declined Boxes (list box numbers) & Reason For Decline
(TL: Not on Box Transfer List  BM: Not boxed/marked properly  NF: Not found for pickup)
Initials
Accepted
New Boxes
Boxes of
Interfiles
Returning
Boxes
Boxes of
Refiles
Boxes Delivered By:
Signature
Printed Name
Date Delivered
VSARA-28
Rev. 03/2018
Vermont State Archives and Records Administration
Office of the Secretary of State
1078 US RTE 2, Middlesex ● Montpelier, VT 05633-7701 ● Tel: (802) 828-3700 ● Fax: (802) 828-3710
RECORDS DELIVERY REQUEST (RDR)
State offices making their own arrangements to deliver boxes to the State Records Center must
submit this form no later than the first Wednesday of the month in which the records will be
delivered. All scheduled deliveries must be approved by the State Records Center Supervisor
prior to delivery. Upon delivery, State Records Center staff will verify that all boxes have been
transferred according to the information on the approved Records Delivery Request (RDR) and
Box Transfer List (Form VSARA-05).
Instructions
Boxes
Boxes must be properly labeled.
o New boxes for storage must be clearly marked with department prefix and box number.
o Returning boxes must have the State Records Center’s box label on them.
Only approved storage boxes (STAPLES item number 656762) will be accepted
When preparing new boxes for storage:
o The State Records Center must approve a Box Transfer List (Form VSARA-05) prior to pickup.
o No used boxes will be accepted.
Files
Refiles and interfiles must be boxed separately.
o Interfiles are new files to be merged into existing boxes.
o Refiles are files that were checked out from boxes in the State Records Center.
Boxes must be clearly labeled as containing either Refiles or Interfiles.
Files will be returned if they do not have the proper sheet attached:
o Interfiles must have an Interfile Transfer Cover Sheet (Form VSARA-06) attached.
o Refiles must have the original request email attached.
Files will only be accepted in reasonably sized boxes (standard records boxes or standard paper boxes).
All Items
Boxes in the following conditions will not be accepted and will be returned at the agency’s expense.
o Boxes that are torn, overstuffed or bulging.
o Boxes that are labeled incorrectly and/or missing the necessary forms.
o Boxes that are not sealed with a taped cover.
Items not listed on this form will not be accepted. Be sure to list all box numbers.
Agencies are responsible for transferring their records in a safe, secure manner and any noticeable damage or loss of records will be
reported to the agency upon discovery.

Download Form VSARA-28 Records Delivery Request (Rdr) for Agencies Making Their Own Delivery Arrangements - Vermont

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