Instructions for Certificate of Destruction

The Certificate of Destruction Form documents the destruction and/or transfer of official records per the approved Records Retention Schedules and the Georgia Records Act.

Do not use this form to document destruction of non-records such as reference material, and personal documents, etc.

Before the university can destroy official records:Sample Certificate of Destruction Form

  • the retention period in the approved Board of Regents Records Retention Schedules must have expired
  • they must not be subject to pending investigation (including requests under the Georgia Open Records Act and Freedom of Information Act), or litigation, and all required audits must be closed
  • the Certificate of Records Destruction Form must be completed with all signatures

1.    Enter the full name of the Division, College, or School 

2.    Enter the full name of the Department / Unit and Area

3.    Enter the full name of the person completing the form
       (to whom any questions about the form or records may be directed)

4a.  Direct campus telephone number of the person completing the form 
       (call center and phone tree numbers will not be accepted)

4b.  E‐mail address of the person completing the form

5.    Complete columns a - f for each record series to be destroyed and/or transferred:

a.     Use the records series number corresponding to the records series title in column 5b
b.     Exact records series title as listed on the approved retention schedules
c.     Retention period as listed in the approved retention schedules
d.     Enter the inclusive date range using mm/dd/yyyy from oldest to most recent
e.     Include a brief note, identifiers, or the unit name records are being shipped
        This column is optional, but are required if transferring custody of official records 
f.      Select from the drop-down the disposition for each record series, 
        i.e., 3rd party destruction, shred only, delete only, shred and delete, trash, or transfer

Routing Instructions for Signatures

Line 6.   University Records Managment Officer will review, digitally sign, and
              forward to Approving Official.

Line 7.   The Approving Official (unit head/ chairperson) signs and forwards
              to unit’s designated Records Management Liaison (RML).

Line 8.   The RML digitally signs and dates form affirming records deposition.
              For records destruction or transfer after all signatures are collected


Save the completed Form on the Records Management Liaisons Google Team Drive in the folder “Certificates of Destruction by unit” using the approved file scheme of the four-digit year, two-digit month and day, division or college acronym, and unit name spelled out.


Certificate of Destruction (fillable)

For access to the fillable features, download, save, and open form using Adobe Acrobat DC.