Email address *

Name *

Address *

Phone *

Department/Office/Unit (enter N/A if not on campus) *

UDDS [6 digit] (enter N/A if not on campus) *

Number and title of all associated records schedules (if known)

Summary of Materials/Collections *

Person to contact for questions if different than above (include name, phone, email)

Name of Archives staff you're working with (enter "No One" if you're currently not working with staff). *

Paper Records Disclaimer

Answer the following questions related to the paper records that are ready for transfer to the University Archives. The Archives staff will work with individuals to ensure collections/materials are successfully moved.

PAPER: Number of boxes *

PAPER: Do the materials contain any of the following information? (check all that apply) *

Social Security Numbers Passwords or PINs Credit Card Numbers Medical history Personnel history Performance Evaluations Salary negotiations or personal financial matters None of the above Other

If other, please specify

PAPER: List folder titles where the above information exists (enter N/A as needed) *

PAPER: Describe efforts taken (or will be taken) by the creating group to segregate or flag personally identifiable (PII) or statutorily restricted information prior to transfer. (enter N/A as needed) *

PAPER: Describe efforts taken (or will be) to remove non-records, transitory records, and/or personal materials prior to transfer. (enter N/A as needed) *

PAPER: Completed inventory spreadsheet (provided by Archives staff) *

Yes No

Electronic Records Disclaimer

The following are ways Archives can currently accept electronic records: hard drive/removable media, CDs, DVDs, email, flash drive, Box or other cloud sharing services. If none of these transfer methods work for you, contact Archives staff for guidance. Archives staff will work with donors as needed to ensure successful transfer.

ELECTRONIC: Do the materials contain any of the following information? (check all that apply) *

Social Security Numbers Passwords or PINs Credit Card Numbers Medical history Personnel history Performance Evaluations Salary negotiations or personal financial matters None of the above Other

If other, please specify

ELECTRONIC: List folder titles and/or file paths where the above information exists (enter N/A as needed) *

ELECTRONIC: Describe efforts taken (or will be taken) by the creating group to segregate or flag personally identifiable (PII) or statutorily restricted information prior to transfer. (enter N/A as needed) *

ELECTRONIC: Describe efforts taken (or will be) to remove non-records, transitory records, and/or personal materials prior to transfer. (enter N/A as needed) *

ELECTRONIC: Date(s) or date range of collection content (ex. 2005 or 2010-2012) *

ELECTRONIC: Total size of files being transferred (enter unsure as needed) *

ELECTRONIC: Total number of folders (enter unsure as needed) *

ELECTRONIC: Total number of files (enter unsure as needed) *

Electronic File Formats

For the sections below, indicate what type(s) of file formats are included.

ELECTRONIC FILES: Microsoft Office (check all that apply) *

Word Excel Access Publisher PowerPoint None Other

If other, please specify

ELECTRONIC FILES: Images (check all that apply) *

JPEG TIFF PNG None Other

If other, please specify

ELECTRONIC FILES: Email (check all that apply) *

PST MSG MBOX None Other

If other, please specify

ELECTRONIC FILES: Adobe (check all that apply) *

PDF PDF/A None Other

If other, please specify

ELECTRONIC FILES: Zip or other compressed files *

Yes No Other

If other, please specify

ELECTRONIC FILES: Audio (check all that apply) *

.WAV .AIFF .WMA .MP3 .MP4 None Other

If other, please specify

ELECTRONIC FILES: Video (check all that apply) *

.AVI .MP4 .MOV .WMV .JPEG2000 None Other

If other, please specify

ELECTRONIC FILES: Database (check all that apply) *

.ACCDB .MDB .DBF .SQL None Other

If other, please specify

ELECTRONIC FILES: Webpages (check all that apply) *

.HTML None Other

If other, please specify

ELECTRONIC FILES: List other file formats or enter N/A *

Anything else you'd like the Archives staff to know about the transfer/donation?