Untitled
Records Inventory Data Worksheet
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See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
Date Span
I Department
ITown Clerk
Government Agency
Record Series Title
Records Series
Description
(describe content
and characteristics
of records)
Ordinance
----..--) /":7.. 1/,\\
t' r ~A
r Alphabetical
r Numerical
Arrangement \e' Chronological
r Alphanumeric
r Other (specify) I
r Not Scheduled Retention per;Odl
r Permanent
Retention
r Historic
\e' Scheduled Schedule # 15.[5] .'1 Schedule IMU-1 I
Location Ivault
Format \e' Paper r Audio-visual r Micrographic r Electronic
Total Quantity \e' Cubic Feet: r Items Amount: 1<1 I Type of Items: I
Annual \e' Cubic Feet Amount: 1<1 I I Items I I
Accumulation
Frequency of Use rDaily r Weekly r Monthly r Seldom \e' Never
Restrictions on Use IN/A
Records Are: In Poor r Vital (Essential \e'Official Copies
r Condition to Operations)
Name of Person Completing Record IChristine Fulton .1 Date 105/18/2011 I
New York State Archives
JCM (2011-01-05)