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Agency Schedule Detail

Authorization Number :  845-0486
Agency Series No. :  IC-COMM-03
Status :  Active
Agency Web Link : 
Agency :  OIC
Confidential Description : 
Division :  OICAADM
Vital Description : 
Section : 
Record Title :  Midday Wellness Program Request Form
Revision :  0
Record Description :  This document helps expedite participation in the agency''''''''s Midday Wellness Program. It establishes a written schedule of when & how each participant will partake in the Program. No medical information about each participant is displayed on this form.
Retention Period Retention Justification Media Code Method of Disposal
Retain until no longer of administrative value, then destroy. Paper Recycle

Approvals

Status Name Title Date
Approved Kevin Palicki Records Officer 7/27/2009 2:40:00 PM
Approved Michael Hardenbrook Record Administrator 7/30/2009 9:28:00 AM
Approved Martin Meeks State Auditor 7/30/2009 12:39:00 PM
Approved Fred Previts State Archivist 7/31/2009 8:22:00 AM

Notes

Date Reason User

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