HomeMy WebLinkAboutR-14-04 Records Mgmt PolicyRESOLUTION NO. R-14-04
A RESOLUTION OF THE CITY OF SEBASTIAN, INDIAN RIVER COUNTY,
FLORIDA, ADOPTING A NEWLY REVISED CITY OF SEBASTIAN RECORDS
MANAGEMENT POLICIES AND PROCEDURES MANUAL 2014, AS THE
CITY'S OFFICIAL RECORDS MANAGEMENT POLICY; PROVIDING FOR
FUTURE AMENDMENTS BY THE CITY CLERK IN ACCORDANCE WITH
UPDATED FLORIDA RECORDS LAW AND NON -SUBSTANTIVE
ADMINISTRATIVE PRACTICES; PROVIDING FOR REPEAL OF
RESOLUTIONS OR PARTS OF RESOLUTIONS IN CONFLICT HEREWITH;
AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, the City Clerk as the designated Records Management Liaison Officer in
2002 brought forward the first City Records Management Policy which was adopted by City
Council by Resolution No. R-02-34 and later amended by adoption of Resolution No. R-07-12;
and
WHEREAS, over the past year, the City Clerk has endeavored to streamline the records
management process to make it easier for City staff to properly maintain their records and
dispose of them in keeping with Florida Records law; and
WHEREAS, the newly revised City of Sebastian Records Management Policies and
Procedures Manual 2014 is presented for approval by Council and incorporates more
streamlined policies, procedures and forms, recognizes recent Council action to assign the
Police Chief as RMLO for law enforcement records by ordinance, includes the establishment of
a City records inventory to eliminate unnecessary paper filing, a Citywide retention schedule to
better assist staff in retention and final disposition of records, and acknowledges the prevalence
of increased use of electronic record.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
SEBASTIAN, FLORIDA as follows:
Section 1. The City of Sebastian Records Management Policies and Procedures
Manual 2014, as attached hereto as Exhibit "A", is hereby adopted as the City of Sebastian's
policy on Records Management; provided, however, that in the event of any conflict with Law
Enforcement records policies and procedures, the Law Enforcement policies and procedures
shall prevail.
Section 2. The City Clerk is authorized to amend the manual from time to time based
on non -substantive administrative practices and Florida records law revisions. Revised pages
will reflect the revision date.
Section 3. Resolution No. R-07-12 is hereby repealed.
Section 4. This Resolution shall take effect upon its adoption.
The foregoing Resolution was moved for adoption by Coy
seconded by Hill , and upon, being put to a vote, the vote was as
follows:
Mayor Bob McPartlan aye
Vice Mayor Jim Hill aye
Council Member Jerome Adams aye
Council Member Andrea Coy aye
Council Member Richard Gillmor aye
The Mayor thereupon declared this Resolution duly passed and adopted this 26th day
Of February 2014.
CITY OF SEBASTIAN, FLORIDA
By: ✓
Bob McPartlan, Mayor
ATTEST:
t
Sally A. Maio, MC
City Clerk
Approved as to Form and Content for
Reliance by the City of Sebastian Only:
Robert A. Ginsburg, City "Attorney
K
CITY OF SEBASTIAN
RECORDS MANAGEMENT
POLICIES AND PROCEDURES MANUAL
2014
INDEX
Introduction to Records Management — Overview of Florida Statutes and Florida Administrative
Code Provisions
List of Florida Statutes 119 & 257, Administrative Code, Helpful Records Management
Information, and Records Retention Series Links
City of Sebastian Records Management Policies and Procedures
Policy 1: Appointment of Records Management Liaison Officers
Policy 2: Records Management Committee
Policy 3: Citywide Records Inventory — Location of Record Copy (Master)
Policy 4: Public Records Requests and Fees
Policy 5: Electronic Records and Media
Policy 6: Records Retention Schedule — City Retention List
Policy 7: Records Storage, Disposition and Destruction, Annual Compliance
Policy 8: Vital Records
Policy 9: Exempt & Confidential Records, SSN Collection Policy w/ Collection Policy
Statement and Request Form
Forms:
Box Label
Records Transmittal (Content of Box)
Records Disposition Form for Destruction
Volume Guidelines
E
Listed below are links to current State laws and administrative codes all City
personnel should become familiar with as well as information provided regarding
records management best practices provided by the Florida Department of State
Division of Library and Information Services.
Florida Department of State — Division of Library and Information Services — Information
for Records Managers
httD://dlis.dos.state.fl.us/index Records Manaaers.cfm
Chapter 119 Florida Statutes (Public Records)
http://www.flsenate.gov/Laws/Statutes/2013/Chapterl 19
Section 257.36 Florida Statutes (Records and Information Management)
htto://www.flsenate.aov/Laws/Statutes/2013/Char)ter257
Chapter 1 B-24.001 Florida Administrative Code (General Public Records
Scheduling/Dispositioning) and Chapter 1 B-24.003 Florida Administrative (Records
Retention Scheduling and Dispositioning)
httD://dIis.dos.state.f1.us/barm/rules/1 B24FAC.cfm
Chapter 1 B-26.003 Florida Administrative Code (Electronic Recordkeeping)
http://dIis.dos.state.f1.us/barm/ruIes/lB26 003FAC.cfm
The Basics of Records Management
httD:HdIis.dos.state.f1.us/barm/handbooks/basics
State of Florida Records Schedules
GS1-SL (State & Local Government Agencies)
http://dlis.dos.state.fl.us/barm/genschedules/GS1-SL-2013 Final.doc
GS2 (Law Enforcement)
http://dIis.dos.state.f1.us/barm/qenschedules/GS2-2008-Rev2010.doc
GS3 (Elections)
http://dlis.dos.state.fl.us/barm/genschedules/GS3 2012.doc
City Retention List (provided under separate cover)
3
Introduction to Records Management - Overview of Florida Statutes and
Administrative Code (FAC) Provisions
Florida Statutes Chapter 119 provides that records of public agencies are open to public inspection
and defines public records as "all documents, papers, letters, maps, books, tapes, photographs,
films, sound recordings, data processing software, or other material, regardless of the physical
form, characteristics, or means of transmission, made or received pursuant to law or ordinance or
in connection with the transaction of official business by any agency'.
Florida's records management program promotes the efficient, effective, and economical
management of public records. Proper records management ensures that information is available
when and where it is needed, in an organized and efficient manner, and in an appropriate
environment.
Records management is more than retention, storage, and disposition of records; it entails all
record-keeping requirements and practices that allow an organization to establish and maintain
control over information flow and administrative operations. Florida's records management
program is authorized by Section 257.36, Florida Statutes and applies to public records as defined
in 119.011(12), F.S.
Records management seeks to control and manage records throughout their life cycle, from their
creation through active use, inactive storage, and final disposition. Managing records provides
space savings, reduced expenses for filing equipment, increased efficiency of information retrieval,
compliance with records retention requirements, identification and protection of vital and historical
records, and control over creation of new records. FS 119, FS 257.36 and FAC rules provide the
following:
• Access to public records is a right of any individual and providing access to public records is
a duty of each public agency
• Every person who has custody of a public record shall permit the record to be inspected and
copied by any person desiring to do so, at any reasonable time, under reasonable
conditions, and under supervision by the custodian of the public records
• Establishes maximum fees for public records requests charged by public agencies
• Anonymity is the right of any requestor of public records and public agencies may not
require written requests for public records
• Certain records as set out in FS 119.071 may be considered confidential or exempt and may
not be disclosed except to designated individuals/agencies or may need to be redacted prior
to disclosure
• Electronic records (email, text, message) must be treated in the same manner as paper
records and based on content of the message
• Each Agency shall appoint a Records Management Liaison Officer (RMLO)
• All public records must be maintained in the building in which they are ordinarily used
• Insofar as practicable, a custodian of public records of vital, permanent, or archival records
shall keep them in fireproof and waterproof safes, vaults, or rooms fitted with
noncombustible materials and in such arrangement as to be easily accessible for convenient
use
• The State of Florida Division of Library and Information Services of the Department of State
provides rules to establish retention schedules and a disposal process for public records
• The record (master) copy of a public record may be destroyed or otherwise disposed of only
in accordance with retention schedules established by the division.
• Duplicate copies of all records, called OSA (obsolete, superseded, or administrative value
lost) by the State, can be destroyed without documentation.
4
City of Sebastian Records Management Policies and Procedures
PolicV 1: Appointment of Records Management Liaison Officer
The City shall appoint a Records Management Liaison Officer (RMLO) in accordance with
Florida law, and the RMLO shall serve as the agency contact with the State of Florida,
coordinate the City's Records Management Program, coordinate and accommodates public
records requests, and file annual compliance reports to the State of Florida.
Procedure:
The City in Chapter 2.2 of the Code of Ordinances has appointed the City Clerk as RMLO for
general administration and the Chief of Police as the RMLO for law enforcement records.
Policy 2: Records Manaqement Committee
A Records Management Committee consisting of at least one representative of each
department shall be formed and meet periodically to coordinate records management practices
and to disseminate records management information back to each of their respective
department's staff and new hires.
Procedure:
Each department will assign a staff member as the department's "Records Management
Liaison." This staff person shall be a member of the Records Management Committee.
Members of the Records Management Committee will meet on an as -needed basis to review
records laws and best management practices as well as formulate new procedures. The
Records Management Committee members will educate other personnel within their
departments on the importance of records management and they shall administer their
department's records through the City Clerks Office.
Records Management Committee Members
GENERAL ADMINISTRATION
CITY CLERK
Sally Maio (RMLO)
Jeanette Williams
Records Clerk
ADMINISTRATION SERVICES
FINANCE DIVISION
Debra Krueger
Nancy Viedt
HUMAN RESOURCES DIVISION
Vaunette Davis
MIS DIVISION
Barbara Brooke -Reese
CITY MANAGER
Jean Tarbell
COMMUNITY DEVELOPMENT
AIRPORT DIVISION
Joe Griffin
BUILDING DIVISION
Linda Lohsl
PLANNING DIVISION
Jan Kin
GOLF COURSE
Joy Green
PUBLIC WORKS
Linda Kinchen
LAW ENFORCEMENT
PD ACCREDITATION
Chief Michelle Morris (RMLO)
PD PERSONNEL
Debra Curr
PD 911 -AUDIO REQUESTS
Gloria Brown
PD RECORDS
Qwontrae (Shawn) Sands
CODE ENFORCEMENT
Susan Lorusso
5
Policv 3: Citvwide Inventory — Location of Record (Master) Co
The Records Committee members will inventory the records in their department and then meet
to determine which department is maintaining the record (master) copy of each record type, and
what departments are maintaining duplicates of that record, and then determine if retention of
duplicates is necessary. The ultimate goal will be a citywide records inventory.
The Committee will also determine whether record (master) copies are being maintained too
long in accordance with established Records Retention Schedules. Maintaining certain
documents that have archival value beyond the State specified retention time may be important
to City management and it is then appropriate to maintain the records, however, if the agency
retains those records and there are public records requests for those records, the agency must
provide them if and when requested.
Creating a good inventory will assist in all agency personnel knowing where a record can be
obtained and will assist with best management practices for public records requests.
Policy 4: Public Records Requests and Fees
City personnel shall provide public records in accordance with Florida law in a reasonable time
to the very best of our ability. The City will establish a fee schedule in accordance with Florida
law, including imposition of a special charge if the nature or volume of public records requested
to be inspected, examined, or copied is such as to require extensive use of information
technology resources or extensive clerical or supervisory assistance by personnel of the
department or Charter office involved, in addition to the actual cost of duplication.
The City is not required by law to generate or create documents in response to requests for
records. If there are records that in total will satisfy the request, provide them, but you are not
required to consolidate information into a report to satisfy a request for public records. In certain
circumstance it may be the directive of the City Manager to do so to satisfy an inquiry.
Whenever feasible and a request is not extensive, we will provide records which are stored in
Laserfiche or other electronic format by e-mail at no cost or advise requestors where they can
locate the record on-line.
Procedure: All public records requests whether written or verbal (EXCEPT those that are simple
requests for copies of documents which a department has in their possession and knows
without question contain no confidential or exempt information) shall be initiated through the City
Clerk's office via the RMLO, i.e. City Clerk for general administration or Chief of Police for Law
Enforcement matters or Law Enforcement personnel or their designees. Public Records
requests will be forwarded by email to the appropriate department(s), and the RMLO will keep
the City Manager and City Attorney informed as appropriate. If a request is verbal and the
individual has requested anonymity, the name shall remain confidential.
If a department is asked for a copy of something that they keep in their office and can provide it
immediately and the department liaison is sure there is no confidential or exempt information in
the document, provide it. If a department is asked for records and it is deemed to be beyond
something described above, forward the request to the City Clerks office or PD as appropriate.
The RMLO or designee will prepare a written request to department(s) seeking the requested
information, with cc to the City Manager and City Attorney, with or without the name of the
requestor as disclosed or not disclosed. The records held by any of those departments should
be forwarded to the City Clerks office for compilation to provide to the requestor. If a department
does not have any of the records requested they should acknowledge that as well. The records
6
will then be reviewed for confidentiality or exemption, redacted accordingly, and provided to the
requestor in a reasonable time with the fee as set out in our fee schedule. Copies of records
provided through records request shall be retained for one year in accordance with FL law.
If someone asks for information that would require you to create a record in response to the
request or asks questions in regard to the requested records, you are not required by law to
create a new record to meet the request and you are not required by law to answer questions
about records being requested. The City Manager may direct that a report be compiled to
comply with a public records request, but State law does not require it.
Fees for Public Records: Florida Statutes Section 119.07 sets out appropriate fees for records
inspection, examination and duplication which includes extensive use of technology, resources
or extensive clerical or supervisory assistance by personnel of the agency. Please become
familiar with FS 119.07 (1) (a) and (b).
In keeping with FS 119.07 (1), the City has adopted the following fees and extensive use policy.
PAPER COPIES
One-sided copy of 8'/z x 11 or 8'/2 x 14 or 11 x 17
$ .15
Two-sided copy of 8'/2 x 11 or 8'/2 x 14 or 11 x 17
.20
Certification of Record
1.00
Large Mas(per page)
5.00
ELECTRONIC COPIES
Emails, Data Files that can be emailed to re uestor
No charge
Audiota es
3.00
DVDs or CDs
5.00
Shipping & Handling
Actual
Cost
EXTENSIVE USE OF INFORMATION TECHNOLOGY RESOURCES
Over 30 minutes (see policy below)
Actual
Cost of
lowest paid
staff
If the nature or volume of public records requested is to be inspected, examined, or copied is such as to
require extensive use of information technology resources or extensive clerical or supervisory assistance
by personnel of the department or Charter office involved, in addition to the actual cost of duplication, a
special service charge may be imposed. The actual charge shall be reasonable and based upon the
labor costs actually incurred or attributable to the City for the clerical and supervisory assistance required
of such personnel providing the service.
The amount to be charged shall reflect the actual hourly rate of the individual providing the service. In
keeping with the City of Sebastian's commitment to provide open access to public records, there will be
no special service charge for requests requiring thirty (30) minutes or less in actual labor. However, when
a person requests public records which require more than thirty minutes in actual service to locate, review
for confidential information, copy and re -file requested public records, the person will be charged for all
time expended above thirty minutes. Based upon the length of time estimated to provide the service and
the cost of copying, a reasonable deposit may be collected prior to the cost actually being incurred.
Monies collected exceeding the actual cost of assistance and copying shall be returned to the person
requesting the public records.
Nothing herein shall prohibit the City from providing free copies of public records to the news media,
government agencies, and public service groups for purposes of disseminating information to the public,
7
such as, copies of City newsletters, City Council and other City board agendas, and press releases.
Whenever feasible and the request is not extensive, we will provide records which are stored in
Laserfiche or other electronic database by e-mail at no cost or advise requestors where they can locate
the record on-line.
Policv 5: Electronic Records and Media (Laserfiche. Databases. Emails. Texts
All records scanned onto electronic media will be tested periodically by City Clerk staff and MIS.
MIS will run a system backup and store the backup off site. This supersedes State law
requirement to test all imaged documents every 10 years. (This does not include audio and
video tapes)
As much as is reasonably possible, permanent and long term records will be scanned to
Laserfiche or any other approved database which is a part of the City's network, and the
electronic version may become the record (master) copy. All departments will be encouraged to
begin using Laserfiche as soon as reasonably and financially able.
Each department will maintain and update their Outlook emails routinely and in a timely manner to
move them to Outlook public folders set up by the MIS Division so they can be retained in
accordance with retention laws and to make them available to public view on the public computer
located in the Clerks' Office. Emails do not have a separate retention type, but are based on their
content. If an email is personal and contains no city business, it is not public record and should be
destroyed and not moved to Outlook public folders. If an email is considered OSA (obsolete,
superceded, or administrative value lost) it may be deleted as soon as it becomes OSA. (Example
— email to invites someone to a seminar, meeting, lunch, etc. and contains no other content that
would make it meet any other description in State Retention Schedules, can be deleted)
City Cell phones issued to staff and Council do not currently have text capability. When and if that
changes, a policy on retaining text messages will need to be established.
Policy 6: Records Retention Schedules — City Retention List
The State of Florida provides retention schedules for use by various agencies. The City shall
utilize Retention Schedules GS1-SL for general administration, GS2 for Law Enforcement, and
GS3 for Election Records. Any retention schedule that deviates from the established State
retention schedules has to be approved by the State of Florida.
Procedure: All City personnel shall become familiar with retention schedules and in an effort to
provide easier access and knowledge of proper retention of various records, there has been
created a City Retention Schedule that complies with the State retention schedules but sets out
the familiar name by which the City personnel refers to records, matches them with the State
name, and lists the departments which may keep those record types. This list will be provided to
Departments in word format for searching and updated as State retention schedules are updated.
Policy 7: Records Storage, Disposition & Destruction, Annual Compliance
In 2001, Florida Law was changed to provide that agencies need not seek State approval for
destruction of individual records, as was the past process, but we must still comply with Florida
records law relative to disposition and destruction which is covered in the Florida Administrative
Code as follows:
18-24.003(10) Agencies shall ensure that all destruction of records is conducted in a manner that
safeguards the interests of the state and the safety, security, and privacy of individuals. In destroying
records containing information that is confidential or exempt from disclosure, agencies shall employ
destruction methods that prevent unauthorized access to or use of the information and ensure that the
0
information cannot practicably be read, reconstructed, or recovered. The agency shall specify the manner
of destruction of such records when documenting disposition. Where possible, recycling following
destruction is encouraged.
(a) For paper records containing information that is confidential or exempt from disclosure, appropriate
destruction methods include burning in an industrial incineration facility, pulping, pulverizing, shredding, or
macerating. High wet strength paper, paper mylar, durable -medium paper substitute, or similar water
repellent papers are not sufficiently destroyed by pulping and require other methods such as shredding or
burning.
(b) For electronic records containing information that is confidential or exempt from disclosure,
appropriate destruction methods include physical destruction of storage media such as by shredding,
crushing, or incineration; high-level overwriting that renders the data unrecoverable; or
degaussing/demagnetizing.
(c) For other non -paper media containing information that is confidential or exempt from disclosure, such
as audio tape, video tape, microforms, photographic films, etc., appropriate destruction methods include
pulverizing, shredding, and chemical decomposition/recycling.
(d) Agencies shall not bury confidential or exempt records since burying does not ensure complete
destruction or unauthorized access.
Procedures: All records disposition forms will flow through the City Clerk, RMLO for general
administration or Chief of Police, RMLO for Law Enforcement records or their designees.
Records destruction is handled through the City Clerks office via a recycling contractor which
provides on-site shredding services.
All records transmitted for storage in the Clerks office must be in a 1.5 cubic foot box and include a
completed "Records Transfer Form" and a "Records Disposition Form" with a box label affixed to
the front of the box indicating records description, date range, records series and number,
destruction date and volume. A records volume guide is at the back of this manual in FORMS.
Electronic records, prior to destruction (deletion) which have retention must also have a completed
"Records Disposition Form" indicating records description, date range, records series and number,
and destruction date,. before they can be deleted.
No record (master) copy shall be destroyed without a completed disposition form submitted to
the City Clerk's office and which includes all required information and the signatures of the
Department Head, Department Liaison, RMLO and witness, and has been reviewed and
determined to meet retention.
In addition to records that have met retention and are properly documented, duplicate paper
records and other OSA paper records shall be destroyed only by utilizing the recycling bins
located in four locations in City Hall and PD for monthly on-site recycling. Please do not use
waste receptacles since Florida law prohibits this method of records destruction. Records
destruction for documented records shall be witnessed by City Clerk staff.
Records disposition forms are considered permanent records in accordance with State law and
MUST be retained permanently. The City Clerks office has scanned all records disposition
forms.
State law requires that each RMLO shall file an annual Records Disposition Compliance Form
with the State of Florida Department of State, Division of Library and Information Services. The
City Clerk (general administration) and Chief of Police (law enforcement records) are provided
with and submit those forms annually.
E
Policy 8: Vital Records
Vital records are an integral part of the Records Management Program for the City of Sebastian.
Vital records are those records which are critical to the continuation of government under crisis
or emergency conditions, and to allow us to return to normal operations in a post -emergency
situation.
The City should establish a Vital Records Program as part of its Emergency Management Plan.
Some examples of vital records are, but not limited to, the following:
Computer Backups
Personnel Records
Payroll Records
Financial Records
Accounts Payable/Receivable
Agreements
Permanent Records of the City
Cemetery Records
Property Deeds
Policy 9: Exempt and Confidential Records and Requirement to Establish a Social
Security Number Collection Policy
FS 119.071 General Exemptions provides for exemptions and confidential status for many
records held by a public agency, and all City personnel who deal with public records
dissemination should become familiar before they release any record to any requestor. The
Government in the Sunshine Manual produced by the First Amendment Foundation, goes into
great detail on Exempt and Confidential Records or you can simply refer to FS 119.071.
Portions of certain records must be redacted where there is exempt or confidential information
included in the record and some records may not be able to be disclosed at all under certain
circumstances.
The State of Florida set out a specific policy on collection and disclosure of social security
numbers in 2007, requiring agencies to adopt a policy. The City of Sebastian recognizes that an
individual's social security number is a unique form of identification that can be utilized to obtain
sensitive information regarding that particular individual, however, the City must collect social
security numbers under certain circumstances in order for the City to be able to properly
perform its duties and functions as a municipal corporation and in order to ensure that such
duties and functions are performed accurately and efficiently.
10
City of Sebastian Social Security Collection Policy:
THE CITY OF SEBASTIAN COLLECTS YOUR SOCIAL SECURITY NUMBER ONLY FOR THE
FOLLOWING PURPOSES:
• PERSONNEL MATTERS:
• New Hire Processing for Identification and Tax Purposes
• Volunteer Processing
• Benefits Processing
• BUSINESS TRANSACTIONS:
• Vendor Credit and Qualification
• Tax Reporting
• REGULATORY MATTERS
• Contractor Licensing
• Business Tax Receipts
• PUBLIC SAFETY
• Police Investigations
• Security Card ID Verification
Each individual who provides a social security number to the City of Sebastian shall be provided with a
copy of this statement in compliance with 119.071(5) FS (2013). Additional copies of this social security
policy statement may be obtained by contacting City Hall, 1225 Main Street, Sebastian, FL 32958.
11
cn�
SET�N
HOME OF PELICAN ISLAND CITY OF SEBASTIAN -SOCIAL SECURITY NUMBER REQUEST FORM
Florida Statutes 119.071 (5) (a) 7. a. (1) and (11) and 7.b. provide regulations for agencies to provide commercial
entities (any corporation, partnership, limited partnership, proprietorship, sole proprietorship, firm, enterprise,
franchise, or association that performs a commercial activity in this state) with social security numbers for specific
commercial activities (verification of the accuracy of personal information received by a commercial entity in the
normal course of its business; use for insurance purposes; use in identifying and preventing fraud; use in
matching, verifying, or retrieving information; and use in research activities, but does not include the display or
bulk sale of social security numbers to the public or the distribution of such numbers to any customer that is not
identifiable by the commercial entity) when requested in writing by the commercial entity, and report same
annually to the State of Florida.
Commercial entity name (corporation, partnership, limited partnership, proprietorship, sole proprietorship, firm,
enterprise, franchise, or association that performs a commercial activity in this state):
Commercial entity business mailing address:
Commercial entity business location address:
Commercial entity telephone number:
Statement of specific purpose for which you need the SSNs and how the SSNs will be used in the performance of
your commercial activity (see above for legitimate purposes set out by FS 119.071)
Any person who makes a false representation in order to obtain a social security number pursuant to this
paragraph, or any person who willfully and knowingly violates this paragraph, commits a felony of the third
degree, punishable as provided in s. 775.082 or s. 775.083. (FS 119.071 (5) (a)]
Under penalties of perjury, I swear or affirm that the facts stated herein by me in this document are true.
Legible signature of AUTHORIZED officer, employee or agent of commercial entity and title Date
Printed Name:
State of Florida
County of Indian River
Before me personally appeared who provided
identification or is personally known to me and who signed the above document on
Notary Public
State of Florida
SEAL
My Commission Expires:
12
as
FORMS FOR RECORDS STORAGE:
BOX LABEL
PAPER RECORDS TRANSFER AND DISPOSITION FORM
ELECTRONIC RECORDS DISPOSITION FORM
VOLUME GUIDE
13