LAND RECORDS TRANSFER LIST

							                                                                                                                                VSARA-25
                                                                                                                                  04/2010


                Vermont State Archives and Records Administration
                Office of the Secretary of State
                1078 US RTE 2, Middlesex ● Montpelier, VT 05633-7701 ● Tel: (802) 828-3700 ● Fax: (802) 828-3710 ● www.vermont-archives.org



                                             LAND RECORDS TRANSFER SHEET

  VSARA must have a Land Records Storage Agreement on file for your municipality or county before you may
       transfer records to the State Records Center. Direct questions to recordscenter@sec.state.vt.us.

  Clerk or Supervisor:                                                                                 Date:

  Municipality or County:                                                                              Phone:


Definitions

  Land Record               A document required to establish marketable title and which is filed or recorded in
                            the records of a municipality or county, including all documents filed or recorded
                            pursuant to 24 V.S.A. § 1154.
  Security Copy             A reproduction of a record created and managed to preserve the information in
                            case the original is damaged. For the purpose of this procedure, the definition of a
                            security copy is confined to reproductions in microfilm, electronic media, or
                            similar compressed form.


1. Format of Records                                                       2. Quantity of Records

      Microfilm          16mm            35mm                                Number of Boxes:
      Microfiche                 Compact Disc
                                                                             Number of Items:
      Other:                                                                 (film reels, CDs, etc.)


3. Itemized List of Records

  Prepare the Land Records Data Spreadsheet, which is available by email request to recordscenter@sec.state.vt.us
  or online at http://www.vermont-archives.org/records/local/.

4. Shipment of Records

      I will drop off the records at the State Records Center.
      I am sending the records directly from my office.
      The records will be sent from my reformatting vendor. Name:


I authorize transfer of the records listed above to the State Records Center for storage. I understand that:
    These records will be stored and managed in accordance with the Land Records Storage Agreement on file
      with VSARA for my municipality or county.
    I and my successors may request a copy of the Land Records Storage Agreement at any time.


Signature of Municipal or County Clerk or Supervisor                  Date Signed

 Please send this completed form to the address above (Attn.: State Records Center Supervisor) or scan and send by e-mail to
recordscenter@sec.state.vt.us. Forms submitted by email must be sent directly from the municipal or county clerk or supervisor.