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Agency Schedule Detail

Authorization Number :  15900289
Agency Series No. :  DMR-HR-14
Status :  Obsolete
Agency Web Link : 
Agency :  DMR
Confidential Description :  Records may contain Personal Health Information, 45 CFR 160, 165. 102-106 and 164.500-530, or Social Security Numbers protected by Federal Constitutional Right of Privacy and Federal Privacy Act (5 U.S.C. 552a)
Division :  DMRHUMR
Vital Description : 
Section :  DMRHUMRPERS
Record Title :  Workers Compensation and Occupational Injury Rcds
Revision :  0
Record Description :  All information related to the individual employee claims for compensation, i.e. forms, letters and reports, etc. Accident or Illness Report (ADM 4303); First Report of Injury (FROI-1) and C-84, etc.
Retention Period Retention Justification Media Code Method of Disposal
Retain for 6 years Records may contain Personal Health Information, 45 CFR 160, 165. 102-106 and 164.500-530 Paper Shred

Approvals

Status Name Title Date
Blank Elaine Chaffin Records Coordinator 9/15/2003 11:51:00 AM
Blank Bridget Brubeck Records Officer 10/31/2003 12:52:00 PM
Blank Michael Hardenbrook Record Administrator 11/10/2003 3:43:00 PM
Blank Steve Gutgesell State Archivist 11/17/2003 1:23:00 PM
Blank Martin Meeks State Auditor 11/17/2003 1:23:00 PM
Blank Stephanie Deters Records Officer 6/13/2024 4:33:15 PM

Notes

Date Reason User
6/13/2024 4:33:15 PM Superseded by adoption of general schedule GP-M-08 Stephanie Deters

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