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Records Management Forms

Records Management forms are available on the Intranet under “Forms Central”/ “Record Management.” Each form includes guidelines for use. For more information, email Shelby Beatty or call 937-512-2319.


R1 Form – Records Retention Schedule

A retention schedule is a document that identifies and describes department records at the series level, and provides instructions for the disposition of the records throughout their life cycle. Contact the Records Manager to create or update a department retention schedule.


R2 Form – Certificate of Records Destruction

This form provides the audit trail to document that business records have been destroyed in accordance with the law as part of an approved records retention program. The form must include the following before sending to the Records Manager:

  • Signature of department manager/designated supervisor
  • SCC codes and names of records listed on your department’s Retention Schedule [R1 form].
  • Span dates of the materials to be destroyed.

The Destruction Date is filled in after disposition, and must be on or after approval signature dates. Send the completed Certificate of Records Destruction [R2 form] to the Records Manager via email or campus mail.

Records may be destroyed by departments or during monthly shred days in the Records Center on campus. An R2 Form must be completed for all records listed on department retention schedules [R1 Form] regardless if they are destroyed in office or by the Records Manager. 

If destroying records in-office, fill in the date of destruction and amount destroyed (ex. 2 boxes, 5 files) on the R2 form and return to the Records Manager. Keep a copy for your records.

To transfer records for destruction to the Records Center, contact Facilities or the Records Manager. Boxes are available in the Records Center, if needed.


R3 Form – Certificate of Records Transfer

This form documents the transfer of records to the Records Center for long-term storage, or the Archives to be added to the college’s historical collection. All materials sent to the Records Center or Archives must be packed in approved boxes. Boxes are available in the Records Center. Contact the Records Manager before transfer.

The form must include the following before sending to the Records Center:

  • Signature of the department contact and head of department.
  • SCC codes listed on your department’s Retention Schedule [R1 form].
  • Name of record series.
  • Span dates of records.
  • Number of boxes.

Create a list of file names in each box and place a copy inside.

Send completed R3 forms to the Records Manager. When the approved form is returned to you, arrangements can be made to move the materials to the Records Center.


R4 Form – Request for On-Campus Records Loan/Return to Office

This form ensures that persons requesting access to materials in the Archives & Records Center are authorized users. The form also documents the reference activities and allows the Records Manager to track items borrowed from storage. Offices may also use this form when records must be returned to the department for administrative purposes.

The form must include the following before sending to the Records Manager:

  • Signature of department manager/designated supervisor
  • Description of the materials being requested.
  • Dates (if known).

Send completed R4 forms to the Records Manager to retrieve requested materials.


For more information, email Shelby Beatty or call 937-512-2319.