Agency Schedule Detail

Authorization Number : 760-0845

Agency Series No. : 1156

Status : Active

Agency Web Link :

Agency : DHS

Confidential Description : May contain information that is considered to be confidential in accordance with Ohio Revised Code (O.R.C.) 149.43 and 2913.04(C)

Division : DHSOSHP

Vital Description :

Section : DHSOSHPLEAD

Record Title : LEADS Agency Service Request Form

Revision : 3

Record Description : To record all requests for access, agency moves, agency merges, disconnect, cancellation of service, terminal additions or moves, or other agency modifications. Requests are submitted on form LEADS 0013 and logged for processing.

Retention Period	Retention Justification	Media Code	Method of Disposal
Scan and upload, then destroy.		Paper	Shred
Retained in Leads Portal for 3 years after completion date of the activity/task		Electronic	Delete

Approvals

Status	Name	Title	Date
Approved	Corey Fromille	Records Officer	2/19/2026 10:17:29 AM
Approved	Terri Dittmar	Records Officer	2/19/2026 11:59:41 AM
Approved	Martin Meeks	State Auditor	2/20/2026 9:11:07 AM
Approved	Martin Meeks	State Auditor	2/20/2026 9:11:09 AM

Notes

Date	Reason	User