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Records Destruction Certificate

Instructions for Form PRD 50

Top portion.

  • Date: date form is completed
  • Cabinet: University of Kentucky
  • Department: major sector within University of Kentucky (Lexington Campus, Medical Center, etc.)
  • Division: area, college, school within University of Kentucky sector
  • Unit: office/dept. within University of Kentucky division or leave blank
  • Schedule Date: leave blank
  • Destruction Date: date records are destroyed
  • Destruction Method: indicate shredding, recycling, etc.



  • Complete columns under Agency Use; leave columns under PRD Use blank. Note that multiple series may be entered on one form; for each series, enter the following elements
  • Series No.: series number from the Records Schedule
  • Title of Records: series title as shown in the Records Schedule
  • Date Span: inclusive dates of the records destroyed
  • Cu. Ft.: volume of records destroyed, in cubic feet
  • Approvals and Certifications: leave blank


Submit completed forms:

Email the Word version, as an attachment, to:

Mail hardcopy version to: UK Records Program, 204 Margaret I. King Library 0039

If you have any questions please email or call (859) 257-5257.