Every VMI office generates, receives, or uses records. Although you may not have records that are of long-term historical, legal, or fiscal value, they all must be managed according to the state's Records Retention and Disposition Schedules approved by the Library of Virginia.

Blank Form - Certificate of Records Destruction

Questions? Confused? Need help with the form?
Please contact theVMI Archives 

Before destroying records a certificate of records destruction must be completed. This applies to records held in all formats - paper and electronic.  The destruction process requires that you identify the records using the state's retention schedules, and use the series numbers and names listed on those schedules when completing the form.

Examples and Tools

Before filling out the Certificate of Records Destruction please review this instruction guide or watch the video which explains how to complete the form.   Your office completes signature line #7 (approving official).  Lines # 8 & 9 are reserved for the Records Officer (Archivist).

Here is a volume estimation table which will help when filling out item 6e.

Steps for Completing the Certificate of Records Destruction

1. Download the blank Certificate of Records Destruction
2. Review the Records Retention Schedules to properly identify the records and determine the required retention period. The state has a searchable database which may help you identify the correct series.
3. Complete the certificate of records destruction.  Be sure to include all the required information, print the form, and complete the signature area at line # 7  (form should be signed by the department or unit head, or by authorized delegate).  The Head of Archives will complete other signature lines.
4. Send the completed form via Post mail to MAJ Jeffrey Kozak, VMI Archives. State regulations require that we receive the paper form with the original signatures - we can't accept scanned signatures sent via email or fax.
5. Once the form has been received and reviewed, you will be notified that destruction is authorized.  Do not destroy records until that time. You will be asked to verify the destruction.
6. The original completed form will be sent by the Archivist to the state Records Management office as required.  The VMI Archives retains a copy for 3 years.
7. If you plan to transfer the records to Archives to take advantage of our shredding service for confidential records, please follow these instructions. The Archives does not handle shredding for ROTC departments or Alumni Agencies.

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Save time: Avoid common form errors

• A series should be listed just one time. For example, if you have Purchasing Records for multiple fiscal years, list the type of record one time. Then use the date range to indicate multiple years, for example, 7/2004-6/2007
• You must include the schedule number, series number, and series name exactly as listed on the authorized retention schedule. Do not use "local names" for records on this form.
• You must include under "Date Range" both a month and a year. Years only (e.g. 2001-2004) cannot be accepted.  FY designation (e.g. FY 2008) is also acceptable.
• Estimate the volume of the records in cubic feet or bytes.  This does not have to be exact. Refer to this volume estimation table.
• An authorized signature is required at Line # 7. Send the original signed form to the VMI Archives, ATTN MAJ Jeffrey Kozak. Do not email or fax the completed form. The state requires original signatures.