Box 02
-----, "'" -
~a
Records Inventory Data V\! orksheet
See instructions in PublicrJtio1l1176, j{}venUJ~V tlnd Planning, bdore cornplelinf) this form.
lB.
lb. DEPARTMENT/UNIT
2,
,
.
,
~
o t- cJp
4, RECORDS SERIES DESCTUPTION (Describe content and characteristics of records)
m'~. +i I-eS
6. ~GEMENT
~abetiCal
o Other (Specify):
6a RETENTION ~n'
o Not scheduled "m~O Appraise for historical value
o Scheduled retention:
o Numerical
o Chronological
o Alphanumeric
6b. SCHEDULE AND ITEM NUMBER, OR.REJ\SONJlORP.ROPOSED.RETENTION
8.
o Audiovisual 0 Micrographic
QUANTITY (In cubic feet ornumber of items),
o Electronic
7.
9.
o Cubic feet:
o Items:
Type of items:
10, MlNUALACCUMULATION (In cubic feeL arnumber of items),
o Cubic feeL:
o hems:
11. FREQUENCY OF USE,
o Daily 0 Weekly
12, RESTRICTIONS ON USE
o Monthly
o Seldom
o Never
RECORDS ARE
]3. 0 IN POOR CONDITJON
]4. 0 VITAL (Essential La operations)
]5. 0 OFFlClAL COPIES
16a I AME OF PERf ON COMPLETING FORM
. ~D~ Pr..
16b. DATE
GRS2 (J2I2002)
92.7!ln:lS 92.,Q6 CDC
B (VJ~n