AGENCY: Davis County (Utah). Council on Aging

SERIES: 11132
TITLE: Client record
DATES: 1990-2018.
ARRANGEMENT: None

DESCRIPTION: This form is completed by a service worker to determine whether an individual is eligible to receive services from the agency. It includes applicant's name, address, and social security number; reason for eligibility; birth date, income declaration, indication of action taken (open, close, redetermination), and applicant's and service worker's signatures.

RETENTION

Retain for 4 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

Retention and disposition for this series is authorized by Archives general schedule Title xx eligibility declaration, GRS-424

AUTHORIZED: 10/20/1992

FORMAT MANAGEMENT

Paper: Retain in Office for 4 years after final action and then destroy.

APPRAISAL

Administrative

PRIMARY DESIGNATION

Public

SECONDARY DESIGNATION

Exempt. 45 CFR 1321.51