Request for non-accessioned disposal: PWGSC-TPSGC 0203
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Instructions for fillable PDF forms
Department:
Room no.:
Address:
Telephone:
It is requested that the following described records be destroyed by shredding at a Federal Records Centre Building or by other secure disposal means.
Type of records:
Security classification:
Incl. Years:
Extent (lin. Metres):
NA/TB Authority no.:
Authorized by (signature):
Date:
Print name:
Position:
Signature for receipt FRC:
Date:
Federal record centres
Certificate of destruction
This is to certify that the above described records have been destroyed by:
Witnessed by: (Signature)
Print name:
Date:
Certified by: (Signature)
Print name:
Date: