Temporary Box # of _

Records Inventory & Retention Form

University of Tennessee Records Management Department 220 S. Dudley Street, Memphis, TN 38104

Phone: (901) 448-8471

Dept. Code# College#

1. Department Name
2. Department Account #
3. Current Box Location
4. Contact Person
5. Contact Phone #
6. Contacts Campus Address
7. Dept. Head Approval Sign./Date

RECORDS MANAGEMENT SECTION ONLY

PERM. Box # Aisle Shelf Row Box Forms Received: Records Received Date Entered Destroy Date:

Records Management Department

12. How many years do you need to store these files?

11. Date Range of box contents from to

(m-d-yyyy) (m-d-yyyy)

10. File Arrangement: Alphabetical, Numerical, Other

9. Description

Summary of box contents – 39 Characters only- including Spaces – for report purposes

8. Records Title: _

15 Characters only- including spaces – for report purposes

Return completed form to 308 Hyman (Libraries/Documents/RECORDS Management/2016/New Sheet & Instructions2016)