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PERSONNEL SERVICES DEPARTMENT <br />RECORD <br />RECORD <br />RECORD <br />I <br />RECORD <br />CATEGORY <br />SERIES <br />DESCRIPTION <br />DATES <br />OFFICIAL <br />Union Bank <br />Form signed by employee authorizing leave <br />EE Separated August <br />PERSONNEL <br />Donation Form <br />hours be donated to the Union Business <br />2006 and prior <br />FILES <br />Leave Bank to be used by union leaders for <br />Union Business.* <br />W -4 form <br />Employee's Withholding Allowance <br />EE Separated August <br />Certificate completed by EE authorizing <br />2006 and prior <br />employer to withhold Federal income tax <br />from employee's pay and /or for indicating <br />exemption. ** <br />Please see attached spreadsheet, dated August 30, 2011, listing personnel files to be purged /digitally <br />imaged. <br />* Will be purged <br />** Will be digitally imaged <br />* ** If non - medical records, <br />PREPARED BY: <br />will be purged; if medical records, will be digitally imaged. <br />7 <br />Rosa1 <br />Flores for Date <br />Kathie S. Gonzalez <br />Executive Director of Personnel Services <br />RECORDS DESTROYED: <br />Number of Boxes <br />19C -8 <br />CONSENT BY: <br />Kathie S. Gonzalez Date <br />Executive Director of Personnel Services <br />D BY: <br />Josgoh Straka <br />Interim City Attorney <br />C� �z //,/z0 l <br />Date <br />