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Records Disposal Request

  1. RECORDS DISPOSAL REQUEST

  2. To:

    SHELBY COUNTY PUBLIC RECORDS COMMISSION 980A NIXON DR. MEMPHIS, TENNESSEE 38134 901-222-8175

  3. For PRC Use Only

  4. PLEASE COMPLETE THE FOLLOWING INFORMATION ON ITEMS 1, 2, 3, & 4

  5. 1

    DESCRIBE RECORD IN COMPLETE DETAIL, INCLUDING SERIES TITLE, DATES AND IF INDEXES ARE INCLUDED. PLEASE USE A SEPARATE DISPOSAL REQUEST ON EACH SERIES OF RECORDS.

  6. 2

    RECORD QUALITY/RETENTION PERIOD:

  7. 3

    RECORD DISPOSITION

  8. 4

    APPROVAL

  9. THE ABOVE LISTED RECORDS HAVE BEEN REVIEWED AND ARE READY FOR DISPOSAL.

  10. PLEASE MENTION IF OTHER

  11. Leave This Blank:

  12. This field is not part of the form submission.