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Agency Schedule Detail

Authorization Number :  876-0133
Agency Series No. :  876-0150
Status :  Active
Agency Web Link : 
Agency :  CIV
Confidential Description : 
Division : 
Vital Description : 
Section : 
Record Title :  Office Visit Form
Revision :  0
Record Description :  Documentation as to why a charge was not filed; formerly known as A/B form
Retention Period Retention Justification Media Code Method of Disposal
2 years from office visit date Paper Shred

Approvals

Status Name Title Date
Approved Emily Sanders Records Coordinator 4/25/2017 8:16:00 AM
Approved Desmon Martin Records Officer 6/19/2017 11:50:00 PM
Approved Bunnie Jones Record Administrator 7/19/2017 11:59:00 AM
Approved Martin Meeks State Auditor 7/20/2017 9:24:00 AM
Approved Fred Previts State Archivist 7/20/2017 10:06:00 AM

Notes

Date Reason User

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© 2025 - RIMS, State of Ohio