Appointment of Department Contact
Your Name:
Your Title:
Your Department:
Your Email:

This is to appoint official records contact(s) of this unit. As my official representative, he or she is authorized to sign any or all memoranda relating to the storage and retrieval of the records of this office, in accordance wit the unit's approved records retention schedule.

Name of Primary Contact:
Name(s) of Alternate Contact(s):
Please type one name per line separated by a return carriage.


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