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Get IL LR 4 2018-2024

Sign and send certificate to above address sixty 60 days prior to disposal date. 5. Retain records until approved copy is returned. CONTACT EMAIL 6. Print RECORDS DISPOSAL CERTIFICATE TO Reset APPLICATION COUNTY Local Records Commission Margaret Cross Norton Building Springfield IL 62756 217-782-7075 FROM Agency Division ADDRESS Street P. O. Box Directions 1. Fill in all blanks and columns. 2. Application item numbers must be listed in numerical order. City ZIP Code 3. Record series titles must be listed as they appear on application* CONTACT TELEPHONE 4. This form can be found online at http //www. cyberdriveillinois. com/. ITEM NO. RECORD SERIES TITLE INCLUSIVE DATES MONTH/YEAR VOLUME OF RECORDS Cu. Ft. or MB/GB Total Volume from all pages Cu. Ft. MB/GB 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 I hereby certify that in compliance with authorization received from the Local Date Approved by ILSOS Signature Prepared by Print name and title on line above Printed by authority of the State of Illinois. O. Box Directions 1. Fill in all blanks and columns. 2. Application item numbers must be listed in numerical order. City ZIP Code 3. Record series titles must be listed as they appear on application* CONTACT TELEPHONE 4. This form can be found online at http //www. cyberdriveillinois. com/. ITEM NO. RECORD SERIES TITLE INCLUSIVE DATES MONTH/YEAR VOLUME OF RECORDS Cu. Ft. or MB/GB Total Volume from all pages Cu. Ft. MB/GB If any of the above records are microfilmed I hereby certify that they have been reproduced in compliance with standards given in Sections 4000. Ft. or MB/GB Total Volume from all pages Cu. Ft. MB/GB 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 I hereby certify that in compliance with authorization received from the Local Date Approved by ILSOS Signature Prepared by Print name and title on line above Printed by authority of the State of Illinois. .

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