Records Transmittal Form

This form is to be used by offices with approved records retention and dispositions schedules that require transfer of records to the Archives and university records center. This form notifies the university archivist of an impending records shipment and represents the official documentation of that shipment. Please document the shipment of only one record series per form. Send one copy of the completed sheet to the university archives (LRC 114) and include one copy in the first box of the shipment.

To be completed by the transferring office:

Department/Office:

Name of Sender:

Phone:

E-mail:

Are the Records Confidential?
Yes
No

Retention Schedule Number:

Record Series Title:

Inclusive Dates:

Quantity (number of boxes or items):

Comments:

Please print off this page and put it in the first box of the shipment. For more information see the transfer procedures.