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Records Management Related Forms

Forms and documents are in Adobe PDF unless otherwise indicated. Alternative formats may be in Microsoft Word or Micosoft Excel. Forms are listed by function and section.

Records Officer Designation

  • 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 Officer Designation Form SSARC-940 
  • Records Officer Designation Guidance SSARC-940G
  • Records Officer Designation Procedures SSARC-940P

Role Designation

  • Use this form to change records center coordinators or to identify other coordinators or contact other than Agency Records Officer.
  • Role Designation SSARC-941 
  • Role Designation Guidance SSARC-941G
  • Role Designation Procedures SSARC-941P

Records Retention Schedule Development

Imaging Exception Application Process

  • Imaging Exception Application Form SSARC-970 (Available in Microsoft Word only) 
  • Imaging Exception Application Form Instructions SSARC-970I 
  • Imaged Records Series List Form SSARC-972 (Available in Microsoft Word only)
  • Agencies List Worksheet Form SSARC-971 (Availavble in Microsoft Word only) 
  • Request for Use of Expedited Disposal Request Process for Converted Documents Form SSARC-930e 
  • Quality Control Procedures Guidance for Imaging Surveys and Exception Applications RM-G-QualityControl
  • Data Migration Statement Guidance for Imaging Surveys and Execption Applications RM-G-DataMigration

Records Disposal

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

Records Center (Temporary) Storage

Records Transfer to State Archives (Permanent Records)

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

Damage Assessment for Records

Form Updates

To assist your agency in verifying that you are using the most current version of our forms we have provided a chronology of when we have updated them since July 2010. If the form is listed below and the revision date on the form you have been using is before July 2010 it needs to be updated.

August 2017

  • RM-G-DefiningActive - Defining Active Guidance
  • Records Damage Assessment Worksheet SSARC-980
  • Records Management Training Classes Registration form Summer/Fall 2017 

January 2017

  • RM-G-DefiningActive - Defining Active Guidance
  • RM-G-HumanResourcesRetentionSeriesGuidance - Human Resources Records Series Retention Guide
  • RM-G-HumanResourcesRetentionSeriesSample - Human Resources Records Series Retention Sample
  • RM-G-DataMigration - Data Migration Statement Guidance for Imaging Surveys and Imaging Exception Applications
  • RM-G-DamageToLocalRecords - Damage to Local Records Guidance

October 2016

  • SSACR-940G - Records Officer Designation Guidance

June 2015

  • SSARC-980 - Records Damage Assessment Worksheet
  • SSARC-940G - Records Officer Designation Guidance
  • SSARC-940P - Records Officer Designation Procedures
  • SSARC-941G - Role Designation Guidance
  • SSARC-941P - Role Designation Procedures
  • SSARC-980 - Records Damage Assessment Worksheet 
  • SSARC-980G - Records Damage Assessment Worksheet Guidance
  • SSARC-980P - Records Damage Assessment Worksheet Procedures
  • RM-G-QualityControl - Quality Control Procedures for Imaging Surveys and Imaging Exception Applications 

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 program 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 Get Records Management Training Page.

For more information or questions, please Contact the Records Management program via fax at 225.922.1220 or via email. Please include your phone number in email correspondence.