Free 41139.PDF - Indiana

Agency name

Indiana Commission on Public Records Records Management Division State Form 41139 (R / 12-98)

NOTIFICATION OF RECORD SERIES ACTION
Division name

Date of previous OCPR approval(s)

INSTRUCTIONS: The items below appear on the attached retention schedule. The retained items have been approved previously by the OCPR. Action is being requested on the items in the AMENDED, DELETED and NEW columns. AMENDED RECORD SERIES ITEM NO. DELETED RECORD SERIES ITEM NO. NEW RECORD SERIES RETAINED RECORD SERIES ITEM NO.

ITEM NO.

Name of Records Analyst

Date prepared

E-mail address

Telephone number