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

Date	Reason	User