CCi - Colorado Correctional Industries



AR Form 450-03C (03/01/20)

COMPUTER INFORMATION

HARD DRIVE REMOVAL CERTIFICATION

PURPOSE: To provide documentation that due diligence is being applied in removing information/hard drives from data devices. Information that must be removed includes: personal, sensitive, or confidential state data, proprietary software, or any other data required by state or federal law.

I certify that all devices listed by serial number on the attached AR Form 450-03A/Form 276 Declaration of Surplus Property have had actions completed as noted to meet data removal standards in accordance with Colorado Data Destruction Policy and Computer, Electronic Media End-of-Life Policy standards published by the Governor’s Office of Innovation and Technology.

Date: ___________________________________________________________________________________

Action or method used: ____________________________________________________________________

Electronic waste recycler name, address and telephone number if applicable:

_________________________________________________________________________________________

Responsible individual

_________________________________________________________________________________________

Printed name Signature

__________________________________________________________________________________________

Title/position

__________________________________________________________________________________________

Agency name Telephone number

Attachment C

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