Sending University Records to Off-Site Storage Form

This form is for use by offices and departments that have a records management account in place with Retrievex for the storage of non-permanent records. Please contact the Records Management Program if you have permanent records.

Fill out one form for each box being transferred.

For assistance with filling out this form, please see the instructions.

Your Name: (required)
Your E-Mail Address: (required)
Telephone Extension (required)

Request Date (required)

Department or Office (required)

Retrievex Account Number (required)

Current Location: Building (required)

Current Location: Floor (required)

Current Location: Room (required)

Retrievex Barcode Number (required)

Alternative Box Number (required)

Destruction Date (required)

Records Series

Container Contents: Alpha-Numeric Sequence and Date of Records (required)

Be sure to print and save a copy of this form for your department or office's records management inventory file.