Records Management Forms

Forms and documents are in Adobe PDF, Microsoft Excel or Microsoft Word format.

Records Officer Designation

• Records Officer Designation Form SSARC-940 (PDF)
• Please Note: To renew your agency's records officer designation due July 1 of each year,  please use the Records Officer Designation form SSARC-940. There is no renewal form. The form mailed to agencies from our office is designed to verify information in our computer system and allow agencies to complete their designation at the same time. This may not occur annually.

Records Retention Schedule Development

• Records Management Inventory Form SSARC-960 (PDF) SSARC-960 (Word)    
• Records Retention Schedule SSARC-932 (Word)
• NEW: Records Retention Schedule Sample SSARC-932 Sample (Word) (See Important Update Section below for further information.)

Imaging Exception Application Process

• Imaging Exception Application Form SSARC-970 (Word)
• Imaging Exception Application Form Instructions SSARC-970I (Word)
• Imaged Records Series List Form SSARC-972 (Word)
• Agencies List Worksheet Form SSARC-971 (Word)
• Request for Use of Expedited Disposal Request Process for Converted Documents Form SSARC-930e (PDF)

Records Disposal

• Request for Authority to Dispose of Records Form SSARC-930 (PDF)
• Request for Authority to Dispose of Records Form Sample SSARC-930-Sample (PDF)
• Request for use of Expedited Disposal Request Process for Converted Documents Form SSARC-930e (PDF)
• Certificate of Destruction Form SSARC-933 (PDF)
• Certificate of Destruction Form Sample SSARC-933-Sample (PDF)

Records Center (Temporary) Storage

• Record Transmittal and Receipt Form (Records Center—Temporary Storage/Microfilm) SSARC-103 (PDF) SSARC-103 (Word)
• Record Transmittal and Receipt Form (Records Center—Temporary Storage/Microfilm) Sample SSARC-103-Sample (PDF)
• Records Box Storage Instructions (PDF)

Records Transfer to State Archives (Permanent Records)

• Louisiana State Archives Records Transmittal Form (For records being transferred to Archives Acquisition Section) F-AS-4 (PDF) F-AS-4 (Excel)

Damage Assessment for Records

• Vital Records Damage Assessment Worksheet SSARC-980 (Word)
• Vital Records Damage Assessment Worksheet Instructions SSARC-980 (PDF)

Form Updates

We have updated many of our forms please use the list below to verify that you are using the most current verison.

March 2013

• SSARC 940 - Records Officer Designation Form

January 2012

• SSARC 932 - Record Retention Schedule
• SSARC 930e - Application for Expedited Process for Request for Authority to Dispose of Records
• SSARC 930 - Request for Authority to Dispose of Records

July 2010

• SSARC 970 - Imaging Exception Application
• SSARC 970I - Imaging Exception Application Instructions
• SSARC 971 - Agency List Worksheet (for Imaging Applications)
• SSARC 972 - Imaged Records Series List (for Imaging Applications)

The Records Management Section has released its Imaging Exception Application process and related forms as of July 1, 2010. A new class on imaging and the imaging exception application process for interested agencies is included in the classes we offer. Information on this new class can be found on our Training Page.

Records Retention Schedule Update (PDF)

Agency Reminder (PDF)

Contact the Records Management Department via fax at 225.922.1220 or via email to recmgt@sos.la.gov or carrie.fager@sos.la.gov or teresa.hardy@sos.la.gov. Please include your phone number in email correspondence.