State Agency Records Disposition Request Forms
State agencies are required by Section 57.05 of Arts and Cultural Affairs Law and 8 NYCRR Part 188 to obtain records disposition authorizations from the State Education Department to legally authorize the destruction or other final disposition of agency records. The General Retention and Disposition Schedule for New York State Government Records authorizes the disposition of records common to most or all state agencies. Agencies may use items in the General Schedule to authorize records disposition provided that the agency Records Management Officer has notified the State Archives of the agency's intent to use the General Schedule. Additional records, including records unique to an agency, are approved for disposition by records retention and disposition schedules specific to the agency. Agencies wishing to obtain approval for records disposition for any of their records can fill out the appropriate forms, available below, and send them to the State Archives for review and approval. State Archives staff can also assist agencies in developing records retention and disposition schedules.
State Agency Records Inventory and Disposition Request Forms
Documents in PDF format require the free Adobe Acrobat viewer. If you don't have it, download here. Documents in Microsoft Word require you to have MS Word 2000 (or higher) installed on your computer.
If you cannot use these forms in the formats available (PDF or Microsoft Word 2000), contact the State Archives at (518) 474-6926 or via e-mail at RECMGMT@mail.nysed.gov and ask to have the forms mailed to you.
Instructions for Completing and Submitting REC-3, REC-4, and REC-5 Forms
These instructions provide information on how to complete the REC-3, REC-4, and REC-5 forms, as well as an overview of the submission and review process.
- Records Disposition Request (REC-3)
REC-3, MS Word
This form serves as the cover sheet for a group of REC-4's and REC-5's (from a single program unit) sent to the State Archives for review and approval. State agencies should complete one form for each program unit. The REC-3 form must be signed by the agency Records Management Officer.
- Retention and Disposition Schedule (REC-4)
REC-4, MS Word
This form summarizes a number of REC-5 forms by listing the series titles and recommended and/or approved retention and disposition for all record series in a single program unit. State agencies should complete one form for each program unit.
- Records Series Description (REC-5)
REC-5, MS Word
This form collects all the information needed about a single records series to help state agencies and the State Archives determine a suitable retention period for the records. State agencies should complete one of these forms for every records series in the program unit they want to schedule.
Imaging Certification Statement
State agencies submitting records disposition schedules to the State Archives that propose to substitute imaged records for original records for retention purposes should complete an Imaging Certification Statement [MS Word version or PDF version]. The Statement should be signed by the agency Records Management Officer and should accompany each program unit schedule submitted to the State Archives that proposes such substitution. One copy of the signed Certification Statement should accompany each Records Disposition Request (Form REC-3) submitted to the State Archives seeking approval of a records disposition schedule for one or more series in a program unit. Completion of this form ensures that the imaged records will be appropriate replacements for the original records. The Statement should be completed and signed by the Records Management Officer and should accompany each applicable schedule request. It certifies
- that the images completely and accurately reproduce the records being imaged;
- that the imaged records will be appropriately maintained to meet required retention periods;
- that the imaging system will not permit additions, deletions, or changes to the records without leaving a record of such actions; and
- that the agency will be able to authenticate the imaged records by competent testimony if necessary.
If an agency Records Management Officer (RMO) has questions about this process, we invite you to contact the State Archives by email at RECMGMT@mail.nysed.gov .