State Form 44905 "Notice of Destruction of County / Local Government Record in Accordance With an Approved Retention Schedule" - Indiana

What Is State Form 44905?

This is a legal form that was released by the Indiana Archives and Records Administration - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2020;
  • The latest edition provided by the Indiana Archives and Records Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of State Form 44905 by clicking the link below or browse more documents and templates provided by the Indiana Archives and Records Administration.

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Download State Form 44905 "Notice of Destruction of County / Local Government Record in Accordance With an Approved Retention Schedule" - Indiana

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NOTICE OF DESTRUCTION OF COUNTY / LOCAL
INDIANA ARCHIVES AND RECORDS ADMINISTRATION
COUNTY / LOCAL RECORDS MANAGEMENT
GOVERNMENT RECORDS IN ACCORDANCE WITH
402 West Washington Street, Room W472
AN APPROVED RETENTION SCHEDULE
Indianapolis, Indiana 46204
State Form 44905 (R8 / 4-20)
Telephone: 317 232-3380
E-mail:
cty@iara.in.gov
This form is to be used only for documenting the destruction of records as scheduled on an approved county / local records retention schedule.
For: a) requests to dispose of records not listed on a retention schedule, or b) requests to transfer records listed on a retention schedule as PERMANENT
to a local historical entity (instead of maintaining them in the originating office or transferring them to the Indiana Archives), use State Form 30505, Request
for Exception to County / Local Retention Schedule or Permission to Dispose of Unscheduled County/Local Public Records (PR-1).
INSTRUCTIONS:
1.
Complete ALL Contact and Record Series Information fields. Record Series Number is REQUIRED for all records listed.
a.
If you do not know the Record Series Number, contact IARA's County/Local Records Management section for more
information.
b.
If the records do not have a Record Series Number, use State Form 30505 as described above.
2.
Send one (1) copy to IARA's County/Local Records Management Section at the address listed above. IARA will respond ONLY if
there is a question or problem with the information on the form.
3.
Delay destruction for thirty (30) days. If there is no contact from IARA within that time, the records may be destroyed.
4.
Complete the Destruction Information fields.
5.
Send one (1) copy of the completed form to the secretary of your County Commission of Public Records, and retain one (1) for
your records.
CONTACT INFORMATION
Name of office
Date submitted to IARA (month, day, year)
County
Address (number and street)
City
ZIP code
Name of contact person
Telephone number
E-mail address
(
)
RECORD SERIES INFORMATION
RECORD SERIES TITLE OF RECORDS
DATE RANGE OF RECORDS
RECORD SERIES NUMBER
VOLUME
TO BE DESTROYED
(m/yyyy to m/yyyy)
(REQUIRED)
(number of boxes, rolls, etc.)
to
to
to
to
to
to
to
to
to
to
to
to
DESTRUCTION INFORMATION
These records were destroyed according to a retention schedule approved for use by the Indiana Oversight Committee on Public Records.
Signature of official destroying records
Date signed (month, day, year)
Printed name of official destroying records
Position
Date records destroyed (month, day, year)
Reset Form
NOTICE OF DESTRUCTION OF COUNTY / LOCAL
INDIANA ARCHIVES AND RECORDS ADMINISTRATION
COUNTY / LOCAL RECORDS MANAGEMENT
GOVERNMENT RECORDS IN ACCORDANCE WITH
402 West Washington Street, Room W472
AN APPROVED RETENTION SCHEDULE
Indianapolis, Indiana 46204
State Form 44905 (R8 / 4-20)
Telephone: 317 232-3380
E-mail:
cty@iara.in.gov
This form is to be used only for documenting the destruction of records as scheduled on an approved county / local records retention schedule.
For: a) requests to dispose of records not listed on a retention schedule, or b) requests to transfer records listed on a retention schedule as PERMANENT
to a local historical entity (instead of maintaining them in the originating office or transferring them to the Indiana Archives), use State Form 30505, Request
for Exception to County / Local Retention Schedule or Permission to Dispose of Unscheduled County/Local Public Records (PR-1).
INSTRUCTIONS:
1.
Complete ALL Contact and Record Series Information fields. Record Series Number is REQUIRED for all records listed.
a.
If you do not know the Record Series Number, contact IARA's County/Local Records Management section for more
information.
b.
If the records do not have a Record Series Number, use State Form 30505 as described above.
2.
Send one (1) copy to IARA's County/Local Records Management Section at the address listed above. IARA will respond ONLY if
there is a question or problem with the information on the form.
3.
Delay destruction for thirty (30) days. If there is no contact from IARA within that time, the records may be destroyed.
4.
Complete the Destruction Information fields.
5.
Send one (1) copy of the completed form to the secretary of your County Commission of Public Records, and retain one (1) for
your records.
CONTACT INFORMATION
Name of office
Date submitted to IARA (month, day, year)
County
Address (number and street)
City
ZIP code
Name of contact person
Telephone number
E-mail address
(
)
RECORD SERIES INFORMATION
RECORD SERIES TITLE OF RECORDS
DATE RANGE OF RECORDS
RECORD SERIES NUMBER
VOLUME
TO BE DESTROYED
(m/yyyy to m/yyyy)
(REQUIRED)
(number of boxes, rolls, etc.)
to
to
to
to
to
to
to
to
to
to
to
to
DESTRUCTION INFORMATION
These records were destroyed according to a retention schedule approved for use by the Indiana Oversight Committee on Public Records.
Signature of official destroying records
Date signed (month, day, year)
Printed name of official destroying records
Position
Date records destroyed (month, day, year)