Free Example Forms (ORAP Appendix) - Oregon

APPENDIX CONTENTS
Records Management Change Request [Form] Notification to State Archives of Intent to Destroy Records [Form] Notification to State Archives of Intent to Destroy Records [Sample] Request for Extension of Records Retention Under UTCR 1.140 (Automatic) [Form] Request and Order for Extension of Records Retention Under UTCR 1.140 (Judicial) [Form] Affidavit in Support of Request for Extension of Records Retention Under UTCR 1.140 [Form] Preliminary Records Purge Order-Multiple Cases [Sample] Preliminary Records Purge Order-Single Case [Sample] Inventory [Samples--31 Discard Order [Sample]

Rev. 2/25/99

Appendix

OREGON JUDICIAL DEPARTMENT RECORDS MANAGEMENT CHANGE REQUEST
Please type or print clearly. Date

Because of the need to research and respond to all requests, your name and address are required.
Your Name Mading Address

city

State

ZIP

Phone Number

0 0 0 0 0

Addition Requested Change Correction Deletion Other

Recommended addition or change:

Related records manual section or rule: Please explain need for change (attach additional sheets if necessary):

Please list applicable statutes, rules, case law, etc., if known:

Return completed form or fax to: Records Management Team Office of the State Court Administrator Supreme Court Building 1163 State Street Salem, OR 97310 [FAX (503) 986-5503]

Rev. 2/25/99

Appendix

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF NOTIFICATION TO STATE ARCHIVES OF INTENT TO DESTROY RECORDS

In accordance with the records retention schedules established by the State Court Administrator pursuant to ORS 8.125(1 l), the following records are eligible for destruction but may have historic value: Description

Quantity Media Form Date(s) of Records Special Problems

Ifyou do not want these records destroyed, please contact the following person at the trial court ofice. If we do not hear from you within 60 days, the records will be destroyed. Dated this -day of
,.
Name (please print) Court Mailing Address City Phone Number State Zip

Rev. 2/25/99

Appendix

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF GRANT
NOTIFICATION TO STATE ARCHIVES OF INTENT TO DESTROY RECORDS

In accordance with the records retention schedules established by the State Court Administrator pursuant to ORS 8.125(1l), the following records value:

Dated this Sth day of Josephine Doe
Name (please print)

P.O. Box 159
Court Mailing Address

Canyon City
City

OR
State

97820
Zip

541-575-1438
Phone Number

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Appendix

IN THE ClRCLllT COURT OF THE STATE OF OREGON FOR THE COUNTY OF

CASE NO. REQUEST FOR EXTENSION OF RECORDS RETENTION UNDER UTCR 1.40 (AUTOMATIC) I Please type or print clearly in dark ink.
I, the undersigned, swear that I am a party to the above-referenced case and request an extension of retention for the following records maintained by the court and associated with this case:
O Records shown by the register maintained under ORS 7.020 as having been received by

the court, other documents maintained in the court file, and the register of actions and judgment docket for this case

O Audiolvideo recordings and logs, court reporter notes, and transcripts
[Note: You must use the judicial extension request form for other records not usually maintained in the case file (for example, search warrants)] I understand that this extension expires one year from the date of entry of this request in the register of actions.
Signature of Requestor Date Print or Type Name of Requestor Mailing Address City Telephone Number State Zip

Bar No.

SUBSCRIBED AND SWORN TO before me this

day of

,.

Notary Public/Court Clerk My commission expires:

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Appendix

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF REQUEST AND ORDER FOR EXTENSION OF RECORDS RETENTION UNDER UTCR 1.140 (JUDICIAL)
Please type or print clearly in dark ink.

I, the undersigned, request extended retention for the following records maintained by the court: (1) Records specific to case number case title v.

O Records shown by the register maintained under ORS 7.020 as having been received by the court,
other documents maintained in the court file, and the register of actions and judgment docket for this case O Audiolvideo recordings and logs, court reporter notes, and transcripts O Other (for example, search warrants) (2) Records not related to a specific case: Based upon the attached affidavit, I request an extension until
Date

Signature of Requestor Date

Print or Type Name of Requestor Mailing Address City Telephone Number State

Bar No.

Zip

ORDER

O Granted until the

day of

With the following limitations:

O Denied
Date Judge's Signature Judge's Name

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Appendix

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF
Affidavit in Support of Request for Extension of Records Retention Under UTCR 1.I40

Must be attached to Request for Extension of Records Retention (Judicial). Please type or print clearly in dark ink. I, the undersigned, affirm that the following are the reasons for requesting this extension:

Signature of Requestor Date

Print or Type Name of Requestor Mailing Address City Telephone Number State

Bar No.

Zip

SUBSCRIBED AND SWORN TO before me this

day of

,.

Notary Public/Court Clerk My commission expires:

Rev. 2/25/99

Appendix

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF
PREI-IMINARY RECORDS PURGE ORDER

Presiding Judge's Signature Print Name

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Appendix

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COLINTY OF State of Oregon
CASE NO. 85-02054

John Brown

PRELIMINARY RECORDS PURGE ORDER

kev. 2/25/99

Append~x

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF INVENTORY OF CASE FILE RECORDS DISCARDED As required by rule 2.205 of the records retention schedules and standards established by the State Court Administrator pursuant to ORS 8.125(1 l), this inventory is for the following CASE FILE RECORDS THAT WILL BE DESTROYED. 1) Under rule 2.260, all remaining recor 84CR0204 84CR2099 84CR2206 State vs. Jame State St g offense felony case files:

Inventory completed: Date Signature and Printed Name

Rev. 2/25/99

Appendix

IN THE ClRCLllT COURT OF THE STATE OF OREGON FOR THE COUNTY OF INVENTORY OF CASE FILE RECORDS DISCARDED

As required by rule 2.205 of the records retention schedules and standards established by the State Court Administrator pursuant to ORS 8.125(1I), this inventory is for the following case files:

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF

INVENTORY OF RECORDS RELlNQLllSHED
As required by rules 1.1 14 md 2.205 of the records retention schedules and standards established by the State Court Administrator pursuant to ORS 8.125(1I), this inventory is for the following CASE FILES RELINQUISHED TO STATE ARCHIVES.

Rev. 2/2s/99

Append~x

IN THE ClRCLllT COURT OF THE STATE OF OREGON FOR THE COUNTY OF DISCARD ORDER

1)

FINDING. The court finds that the cases listed in paragraph two below
a) b) c) Were disposed of by final order rather than final judgment, All financial obligations have written off pursuant to policy, and The minimum retention requir ed by the State Court Administrator, pursuant to OR een met.

RECORDS INVOLVED. T case file records: See attach

le, this order authorizes

SO ORDERED this Presiding Judge's Signature Print Name

Rev. 2/25/99

Appendix