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University Archives Records Transmittal Form

If you cannot use web forms, use the MS Word version.

Required fields are marked in Red

College, Office/Department, or Division:

Your Name:
Position Title:
E-Mail Address:
Phone:
Campus Box:
Building and Room:

Brief Description of Records to Transfer:

Date Span (yyyy - yyyy):
-

Number of boxes:
Or
Number of folders/items:

Box Type:
If other, please specify:

Are there any confidential records included (Yes/No):

List Box or Folder Contents:

Additional Information: