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NHA-GSD-CRD-2022-001

RDSForm 01
RECORDS INVENTORY FORM
for transfer

Box Code No: ________-________-______-______


(Group/Dept/Region) (District/Division) (Year) (control no)

Item No. Disposition


(NHA Folder Period Plan
Records Series Record Description Retention Period
RDS/ NAP No. Covered (Archival /
GRDS) Disposal)

*Note: Box for inventory of records/documents for archiving shall be separated from the records for disposal.

Prepared by: Certified Correct by:

_______________________ Date: _____________ ___________________________ Date: _____________


Records Custodian Name/Signature/Position
Group/Department/Region/District

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