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Records Disposal Request

  1. RECORDS DISPOSAL REQUEST
  2. To:
    SHELBY COUNTY PUBLIC RECORDS COMMISSION 980A NIXON DR. MEMPHIS, TENNESSEE 38134 901-222-8175
  3. For PRC Use Only
  4. PLEASE COMPLETE THE FOLLOWING INFORMATION ON ITEMS 1, 2, 3, & 4
  5. 1
    DESCRIBE RECORD IN COMPLETE DETAIL, INCLUDING SERIES TITLE, DATES AND IF INDEXES ARE INCLUDED. PLEASE USE A SEPARATE DISPOSAL REQUEST ON EACH SERIES OF RECORDS.
  6. 2
    RECORD QUALITY/RETENTION PERIOD:
  7. 3
    RECORD DISPOSITION
  8. 4
    APPROVAL
  9. THE ABOVE LISTED RECORDS HAVE BEEN REVIEWED AND ARE READY FOR DISPOSAL.
  10. PLEASE MENTION IF OTHER
  11. Leave This Blank:

  12. This field is not part of the form submission.