Agency Schedule Detail

Authorization Number : 760-1588

Agency Series No. : 1307

Status : Active

Agency Web Link :

Agency : DHS

Confidential Description :

Division : DHSOSHP

Vital Description :

Section :

Record Title : Title VI - Complaint Form and Title VI - Complaint Log

Revision : 0

Record Description : Title VI – Complaint Form: This form may be used to file a complaint with the Ohio Department of Public Safety for alleged violations of Title VI of the Civil Rights Act of 1964. Title VI – Complaint Log: This form will be used to document a complaint with the Ohio Department of Public Safety for alleged violations of the Civil Rights Act of 1964.

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain five (5) years and then destroy.	Retention period required by the Civil Rights Act of 1964 to report alleged violations of discrimination when applying for the Title VI Federal financial assistance from the Department of Transportation (DOT), including the Federal Motor Carrier Safety Administration (FMCSA).	Paper	Shred
Retain five (5) years and then destroy.	Retention period required by the Civil Rights Act of 1964 to report alleged violations of discrimination when applying for the Title VI Federal financial assistance from the DOT, including the FMCSA.	Electronic	Erase

Approvals

Status	Name	Title	Date
Approved	Mark Contosta	Records Officer	8/6/2018 4:45:00 PM
Approved	Bunnie Jones	Record Administrator	8/10/2018 3:46:00 PM
Approved	Fred Previts	State Archivist	8/10/2018 4:27:00 PM
Approved	Martin Meeks	State Auditor	8/13/2018 9:51:00 AM

Notes

Date	Reason	User