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Get IL LR 4 2008

Fill in all blanks and columns. 2. Sign and send certificate to above address thirty 30 days prior to disposal date. Print RECORDS DISPOSAL CERTIFICATE TO Save APPLICATION COUNTY Local Records Commission Margaret Cross Norton Building Springfield IL 62756 217-782-7075 FROM Agency Division ADDRESS Directions 1. 3. Retain records until approved copy is returned* ITEM NO. Reset Street P. O. Box City ZIP Code CONTACT TELEPHONE CONTACT EMAIL RECORD SERIES TITLE If any of the above records are microfilmed I hereby certify that they have been reproduced in compliance with standards given in Sections 4000. 50 and 4500. 50 of the Regulations of the Local Records Commissions. If the records are digitized I certify that they have been reproduced in compliance with standards given in Sections 4000. 70 / 4500. 70 and will be maintained in compliance with standards given in Sections 4000. 80 / 4500. 80 of the Regulations of the Signature required only if records have been microfilmed or digitized INCLUSIVE DATES VOLUME OF RECORDS Cu. Ft. or MB/GB I hereby certify that in compliance with authorization received from the Local Date Signature Print name and title on line above Prepared by Printed by authority of the State of Illinois. 3. Retain records until approved copy is returned* ITEM NO. Reset Street P. O. Box City ZIP Code CONTACT TELEPHONE CONTACT EMAIL RECORD SERIES TITLE If any of the above records are microfilmed I hereby certify that they have been reproduced in compliance with standards given in Sections 4000. 50 and 4500. 50 of the Regulations of the Local Records Commissions. If the records are digitized I certify that they have been reproduced in compliance with standards given in Sections 4000. 50 and 4500. 50 of the Regulations of the Local Records Commissions. If the records are digitized I certify that they have been reproduced in compliance with standards given in Sections 4000. 70 / 4500. 70 and will be maintained in compliance with standards given in Sections 4000. 80 / 4500. 70 / 4500. 70 and will be maintained in compliance with standards given in Sections 4000. 80 / 4500. 80 of the Regulations of the Signature required only if records have been microfilmed or digitized INCLUSIVE DATES VOLUME OF RECORDS Cu. 80 of the Regulations of the Signature required only if records have been microfilmed or digitized INCLUSIVE DATES VOLUME OF RECORDS Cu. Ft. or MB/GB I hereby certify that in compliance with authorization received from the Local Date Signature Print name and title on line above Prepared by Printed by authority of the State of Illinois. 3. Retain records until approved copy is returned* ITEM NO. Reset Street P. O. Box City ZIP Code CONTACT TELEPHONE CONTACT EMAIL RECORD SERIES TITLE If any of the above records are microfilmed I hereby certify that they have been reproduced in compliance with standards given in Sections 4000. 50 and 4500. 50 of the Regulations of the Local Records Commissions. If the records are digitized I certify that they have been reproduced in compliance with standards given in Sections 4000. 70 / 4500. 70 and will be maintained in compliance with standards given in Sections 4000. 80 / 4500. .

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