RECORDS DESTRUCTION REPORT

INSTRUCTIONS:
	1. This form is for agency information only. State and local governments are required by law (M.S. 138.17, Subd. 7) to permanently retain a list of 
destroyed records. Complete form in Word or by hand. Then submit this completed form to University Archives via email at archives@stcloudstate.edu or by mail at MC 314C.
	2. Use this form to document records destruction under authority of a general or specific agency records retention schedule.
	4. Document only records that are physically destroyed, not records transferred to the University Archives.
	5. Use additional pages as necessary.
	6. Volume chart to determine cubic feet:
Letter Size Drawer = 1.5	Transfer Case (24” x 16” x 11”) = 2.5	
Legal Size Drawer = 2.0	3 x 5 Card 12” Row = 0.1	
Shelving 4’ Letter = 2.3	4 x 6 Card 12” Row = 0.2	
Shelving 4’ Legal = 3.0	5 x 8 Card 12” Row = 0.3	
Record Box (12” x 15” x 10”) = 1.0	Printout 12” Stack = 1.25	

Agency and Division	Person Reporting Destruction	Date	
Address	City, Zip	Telephone	

General Schedule Name or Agency Schedule Number	Section of Schedule Where Record is Listed	Item No. as Listed on Schedule	Record Title 
(use same title as listed on schedule)	Inclusive Dates	Date Destroyed	Quantity in Cubic Feet	

							

							

							

							

							

							

							

							

							

To show that the records destroyed by your office were done so under the “normal course of business,” a this form must be completed and sent to Archives as evidence. For ANY records that you destroy, you must complete this form and send to University Archives. If records are NOT destroyed in the normal course of business, St. Cloud State University may be held liable.

To make the process much easier, fuller versions of the state approved schedule is available by office on the Archives website at: 

http://lrts.stcloudstate.edu/library/special/archives/recordsRetention/default.asp

General Schedule Name or Agency Schedule Number:

•	From the Agency Schedule Number field, which is near the top of the page, enter the number.

Section of Schedule Where Record is Listed:

•	Ignore this field

Item No. as Listed on the Schedule:

•	From the Item No. field, enter the number.

Record Title:

•	The title of the records - enter the phrase.

Inclusive Dates:

•	Enter the date range of the records that were destroyed (e.g., 1985-1999)

Date Destroyed:

•	Enter the date the records were physically destroyed or deleted.

Quantity in Cubic Feet

•	Using the chart on the Records Destruction Report form, estimate how many cubic feet were destroyed. If electronic, please include the total file size in MB or GB.

Once the form has been completed and the records destroyed, send to University Archives at archives@stcloudstate.edu or by campus mail to MC 314C. The form will be retained permanently by University Archives as evidence of the records being destroyed in the office’s normal course of business.

If your office has records that are not on the schedule, DO NOT DESTROY. Please contact University Archives for guidance.