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Section 3: Transmittal and Storage Documentation

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1419 Records Transmittal Form Overview

Districts or divisions sending records for storage at the Records Management Warehouse must use a 1419 Records Transmittal Form, which provides the following:

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  • Serves as documentation to verify that all records shipped were received.
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  • Serves as an index and locator for records in storage.
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  • Is used to provide the Office of Primary Responsibility a detail listing when destruction of the records is coordinated.
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  • Provides an audit trail to document the storage and disposition of official records in accordance with the agency's approved Records Retention Schedule.
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Instructions for Completing 1419 Records Transmittal Form

One 1419 Records Transmittal Form can be used to transmit many boxes of records. Although you may transmit multiple boxes with varying destruction dates with a single 1419 Records Transmittal Form, records management recommends transmitting a single record series with a single destruction date with each 1419 Records Transmittal Form to reduce the possibility of confusion or errors. Following is an example of a completed 1419 Records Transmittal Form:

How to Complete 1419 Records Transmittal Form

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Anchor: #i1026458Table 10-1: 1419 Records Transmittal Form

Step

Block Name

Action
1

District or Division Section/Location

Enter the complete return address of the sender. Include District or Division section and location. Please provide a phone number to contact the sending Districts and Divisions Records Administrator.

2

Date of Request

Date of Transfer.
3

Contact Persons

The form must include the District and Division Records Administrator name (Required), and the Records Coordinator name (Optional) of the District or Division.

The Records Management individual receiving the records will enter their name, date, and sign in the appropriate signature block prior to returning a copy of the form to acknowledge receipt of the records.

4

District and Division Records Coordinator

(Optional)

Enter the name of the Records Coordinator for the District or Division completing the form and transferring the records.

5

Additional Information

Complete any specific information that may be needed. (e.g., when transferring records to Texas State Library and Archives Commission)

6

Request the Accompanying Records Be Sent to Texas State Library and Archives Commission.

Check the appropriate box to indicate Archival Review or Archive.
7

Request That Accompanied Records Be Stored

Check one of the following:

  • Until Destruction Date
  • Permanently
  • Temporarily
8

Storage Location (Receiving Organization Only)

Leave BLANK. Completed by Records Management.  This is where boxes are stored at the TxDOT Records Warehouse.  You will use this number in the future to request boxes once they have been indexed.

9

Box Number

Should contain the temporary box identification numbers (1, 2, 3, etc.) that were marked on the boxes by the sender. You can send multiple boxes with varying record series and destruction dates on the same transmittal. Each box should have a corresponding row in the form. For example, if there are 12 boxes being shipped then the form should list 12 rows.

10

Record Series Title

For each box, enter the Record Series Title from the TxDOT Records Retention Schedule.  The record series title is a general description. You may describe the records as specifically as necessary for your retrieval needs.

  • Pack only a single records series with a single destruction date in a box.
  • In the next column, be sure and include the Agency Item No. from the TxDOT Records Retention Schedule, e.g., ADM 12.
11

Agency Item Number:

For each Record Series, enter the corresponding Agency Item Number from the TxDOT Records Retention Schedule. This entry is required for records sent for storage at TxDOT Records Warehouse or Texas State Library and Archives Commission. (e.g. ADM09)

12

Description and Date of Records

Description and date of records is self-explanatory. Include as much detail as necessary to be able to retrieve needed records. The order of listing records in this column should follow the sequence in which the records are placed in the boxes.

13

Retention Code

List the Retention Code as identified on the TxDOT Records Retention Schedule (i.e.: AC+4)

14

Date Range

List the Start (Month/Year) and End (Month/Year) of Records.

15

Archival Code

For records which have an archival code requirement, check the appropriate box (Archival Review or Archive) as identified on the TxDOT Records Retention Schedule.

  • A - The records must be transferred to the Archives and Information Services Division of the Texas State Library and Archives Commission.
  • R - The Archives and Information Services Division must be contacted for an archival review of the records before disposition. Those records determined to be archival must be transferred to the Archives and Information Services Division for long-term preservation.
  • N/A – No Archival Code, but retention requirements are to store inactive official records.
16

Destruction Date

The date the records can be destroyed in accordance with the sender's approved Record Retention Schedule. Enter a specific date, i.e., 09/1999.

  • Do not pack records with different destruction dates in the same box.
17

Signatures

All required signatures must be completed.


Records Transmittal Form (click in image to see full-size image) Anchor: #HBMONBTPgrtop

Figure 10-2. Records Transmittal Form
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