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Completing the Certificate of Records Destruction

 Blank Form - Certificate of Records Destruction

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

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. 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 & Tools

Before filling out the Certificate of Records Destruction please review this example of a completed form 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

 Blank Form - Certificate of Records Destruction.  

  1. Please view the example before you start. It will save you time.

  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 COL Diane Jacob, VMI Archives. State regulations require that we receive the paper form with the original signatures - they do not 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 bulk shredding services, please follow these instructions


Tips - these will help you avoid having to redo an incorrect form

  • 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 - 7/2004-6/2007

  • You must include the schedule number, series number, and series name as listed on the authorized retention schedule. Do not use "local names" for records on this form.  Please view the example.

  • 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 COL Diane Jacob. Do not email or fax the completed form. The state requires original signatures.