No microfilm will be accepted for transfer to the Illinois State Archives for security purposes unless accompanied by this State Records Security Microfilm Transfer Sheet completed in triplicate. Any microfilm that arrives without the completed form will be returned to the agency from which it came. Unlabeled film boxes will also be returned.

Because of the legal importance of records maintained on security microfilm the State Records Security Microfilm Transfer Sheet requires that the records be documented in detail. This aids the transferring agency in that it gives a clear account of those records which have been placed on security microfilm and are available for use. It also assists the State Archives in servicing the records by supplying easier access to the microfilm being held for the agency.

A State Records Security Microfilm Transfer Sheet can be downloaded in Adobe Acrobat format. The form can be completed using Adobe Acrobat Reader 3.0 or later in your web browser or the file can be saved to disk and used with Adobe Acrobat Reader 3.0 outside your web browser. Macintosh and Windows versions of Acrobat Reader may be downloaded free of charge from Adobe.
 

• To use the form in your web browser with Adobe Acrobat Reader 3.0 or later, simply click on the link below.
• To save the file to disk, right click on the link below and choose a download location. After the file has been saved to disk, you can open the form in Acrobat Reader 3.0 or later and complete it at any time.
• If you need help in filling out this form or need a paper copy sent to your agency, call (217) 782-4866.
   

Instructions for Completing a State Records Security Microfilm Transfer Sheet

When you open the State Records Security Microfilm Transfer Sheet in Adobe Acrobat Reader, the cursor will be located at the first point at which data data should be entered. Use the Tab key to move to the various data entry points or place your cursor where you would like to enter data.

The transferring office is required to fill in all unshaded portions of the form. The shaded portions will be completed by the Illinois State Archives.

Data Entry Points

• Item 1:    Records of: 
  • Agency, Department, Division and Section
    The complete name of the agency, department or division, section or unit whose records have been microfilmed must be completed.
     
  • Send Receipt to
    The name, address, and telephone number of the person to whom the receipt is to be sent must be completed.

• Item 2:    Total No. Rolls Submitted this Date
  The total number of rolls being transferred must appear in the Total No. of Rolls Submitted this Date" box.
   
• Item 3:    Certification
  • State Records Commission Application Number
    The appropriate State Records Commission application number authorizing the microfilming of the record series and authorizing the transfer of security microfilm to the State Archives must be listed. If you do not have a copy of the appropriate State Records Commission Application for Authority to Dispose of State Records, please call the State Records Unit at (217) 782-2647.
     
  • Signature and Date
    The official responsible for meeting the microfilm requirements of the State Records Commission must sign and date the certification section. The official's name and title should be printed or typed on the line below the signature.
     
• Item 4:    Microfilm Content Description 
  • Application Item Number
    The appropriate State Records Commission application item number should be listed for each roll.
     
  • Roll ID Number
    Each roll of microfilm should be numbered separately and listed consecutively on the Transfer Sheet. 
     
  • Title of Records
    Please list the title of the records as listed on the State Records Application.
     
  • Start and End of Roll
    The records at the start and end of the roll also must be listed to aid in locating a particular item on the roll. This may consist of the volume and page number at the beginning and ending of the roll, the inclusive letters of the alphabet or names, the inclusive dates of the records microfilmed, or other similar information.
     
  • Negative or Positive Microfilm
    Enter an N for negative microfilm rolls and a P for positive use copies. The default value is N for negative microfilm, but this can be changed by typing a P over the N.
     

• Item 5:    Acknowledgement
  The acknowledgment for the receipt of the microfilm will be completed by Illinois State Archives personnel. A signed copy will then be returned to the state agency.

Print the completed State Records Security Microfilm Transfer Sheet form in Adobe Acrobat Reader. Prepare one original and two duplicate copies of the State Records Security Microfilm Transfer Sheet. The archives staff will gladly provide assistance to state agencies in completing this form. For assistance please call the Inventory Control Section of the Illinois State Archives at (217) 782-4866.

Download a State Records Security Microfilm Transfer Sheet

Click here to find out how to obtain the Adobe Acrobat Reader.

Download a  State Records Security Microfilm Transfer Sheet now (Requires Adobe Acrobat Reader 3.0 or later).