List one record series per transfer sheet

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List one record series per transfer sheet Powered By Docstoc
					                                          RECORDS TRANSFER SHEET
                            State Records Center
                            2341 South 2300 West
                            West Valley City, UT 84119-2021 (801) 975-4016
                            FAX (801) 974-0336
                            recordscenter@state.ut.us

Instructions                                                                                1. Series Number
          Complete each numbered item on this worksheet.
          List one record series per transfer sheet. Use addendum page if necessary.
          Send RTS to State Records Center for approval. A delivery appointment will be
made.
          Include RTS with transfer.
          If you have questions, call (801) 975-4016.
                                                                                            2. Page 1 of          Pages

3. Agency Name and Mailing Address                                                          4. Records Officer Phone Number




5. Name of Records Officer (Printed or Typed)                                               6. Signature of Records Officer


7. Name of Person Completing Form (Printed or Typed)                                        8. Signature


9. Record Series Title                                                                      10. Total Boxes to be transferred

11. Inclusive Dates (Month/Year) of Records Being Transferred                               12. Does this transfer contain
         From:                                                       To:                    non-paper records?____ Yes ____
                                                                                            No

Signature of Records Center Staff                                                                     Date Received



                                      Description of Records Being Transferred
13. Agency Box      14. Dates of Contents                            15. Summary of Contents of Each Box
     Number              (Month/Year)

                    From:           To:
Revision date: 11/9/99
                                     Addendum Records Transfer Sheet
Agency Name                                                                   Series Number




                                                                              Page ____ of ____ pages


13. Agency Box   14. Dates of Contents                 15. Summary of Contents of Each Box
     Number           (Month/Year)

                 From:        To:

				
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posted:11/4/2012
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