State of West Virginia Records Survey
1. County Office 3. Office Sub-Unit 6. Records Series Title 8. Description (what is the purpose of this records series?) 2. Office Unit 4. Name of Contact Person 5. Telephone No. E-Mail:
7. Date Range of Records
9. File Arrangement Alphabetical by Numerical by Chronological by None Other 11. How often do you access /reference these records? Daily Monthly Weekly Less often
10. Records Format/Medium Paper (size) Microform (type) Machine readable (disk, tape, etc.)_________ Other (specify) 12. Cut-off period for records Calendar year Fiscal year Continuous (no break) Other (specify) _____________
13. Are the records (check all that apply) Originals Does your department originate these records? Yes No Duplicates If duplicated, where are other copies kept? __________________________________ Record or master copy? Yes No
14. Are these vital records (essential to conducting business)? Yes No Explain________________________________ ______________________________________ ______________________________________ ______________________________________
15. ANNUAL Accumulation of the Records Letter/Legal-size drawers Letter/Legal-size boxes Other (specify)
16. TOTAL Accumulation of the Records (include all Storage locations) Letter/Legal-size drawers Letter/Legal-size boxes Other (specify) Location(s) of records
17. Cite any state or federal policy, regulation or law, or professional organizations recommendation pertaining to the actions documented in this series. Please attach a copy of citation.
18. Access to Records (attach copy of citation) No restrictions Protected under the federal or state Privacy Protection legislation Exempt from public disclosure under the federal or state Freedom of Information Act (FOIA) Other legal restrictions (specify)________________________________________________ 19. Your Recommended Retention and Disposition (complete as applicable) A. Total length of retention ______________days / months / years/ permanent B. Retain on-site ______________days / months / years C. Retain off-site ______________days / months / years Office storage Records Storage off-site storage Transfer to State Archives Other D. Reformat after ______________days / months / years microfilm optical disk other Reformat to Retain reformatted material__________________days / months / years 20. Comments/reasons for recommendations listed in No. 19 (include any citations requiring or recommending specific retention).
21. Additional Comments (if needed)
22. Survey Conducted By
23. Date of Survey