Dispose of Records Request Form

The Dispose of Records Request form for churches and/or organizations is available free to download, customize and print 24/7 for your church administrative office, Human Resources Department and/or personal use.



What is the request form for disposing of documents or records?

This form is used prior to destroying or transferring records or documents in your organization's office. Departments must submit this form and obtain authorization before disposing of their records and then file this form.



Most organizations and/or churches have a retention period from which they start disposing of these records. Hard copies and electronic records are to be disposed of when their retention period has ended.

This request form is a valuable tool in an organization to ensure that records are disposed of when the time is appropriate for them to be disposed as the employee and/or volunteer has to submit this request form before ever disposing of their records or documents and has to be signed off to be authorized by the Departmental Records Management and a date with the signature. If it wasn't time for the records or documents to be destroyed then the request form would never get the signature and/or authorization to dispose of the records and this keeps any unexpected disasters from happening which is good for the employee or volunteer and the organization and/or church with the important records.

The form for disposing of documents or records request includes:

  • Church Name - Insert your church or organization's name 
  • Request Form Title - The title of the form is below the church name
  • Date of Request - Insert the date of the request
  • Department - Insert your department name if applicable
  • Control Number - Insert the control number if applicable
  • Contact - Insert the name of the person to contact for this request
  • Phone - Insert the contact's phone number
  • Statement - The following described records have no further legal, fiscal, administrative or historical use to this department. There are no audits, litigation or claims pending or anticipated against them. We certify that they have met [Church Name] retention requirements.
  • Preparer and Date
  • Department Head and Date
  • Records Management Officer and Date
  • Description of Records to be Disposed - Record Title, Retention Period, Date Range of Records (From - To)
  • Departmental Records Management Signature and Date
Click on the link to download the request form below for disposing of records:

Dispose of Records Request Form


If you need to modify this form, try the site: Free PDF Services. You can convert this Adobe file into a Word document free of charge and make the necessary changes.

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If you want to open the file in your browser window, just click on one of the links above. However, if you want to download the file to view later, then right-click on the link and choose "Save Target As" or "Save File As". Then select where you want to save the file on your hard drive.


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Note: These sample forms are meant to serve as example forms and should not be construed as legal documents.  Please contact a legal professional for legal language for your specific organization.


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