Box 014
.. -
~s" i"""""",'~~~:~~~~'~~~;';;~'Z ~~~":~[!~~~:~~""9 "'" Fo"',
la. GOVERNMENT/AGENCY lb. DEPARTMENT/UNIT
1" 0 \,r:l f' ,,\ l-.J Ir- r IJ ~ f\ '" ~ r
2. REcORbs SERlES TITI..E rr J .
~ \( \-.J" t ':. .~ \N
~r ~ '\\ \) \)~
3. DATESPAN
~~
o~\
4. RECORDS SERlES DESCRIPTION (Descri e comem and charactenstics of records)
q~l
~( I" \\ "
5. ARRANGEMENT
o Alphabeucal 0 Numerical
o Other (Specify):
6a RETENTION
o NO[ scheduled 0 Permanent
~Scheduled retention:
\:>~ \~, Ii ~'~t,,~ ~
.~ Chronological
o AJphanumeric
o Appraise for hiswricaJ value
S S "J ~ \.\')
6b. SCHEDULEAND ITEM NUMBER, ORREASONJlORFROPOSEDRETENTION
\
7. LOCATION
C t-l y..r.. v.J L ~ \~
8, (PRMAT
)Il.Paper 0 Audiovisual 0 Micrographic
9. TOTAL QUANTITY (In cubic feel ornumber of items),
"'j{ Cubic feet: \ 0 Items:
10. ANNUAL ACCUMULATION (In cubic reet ornumber of Items),
o Cubic feet:
11. EREQUENCY OF USE,
o Daily 0 Weekly
12, RES1RICTIONS ON USE
N~
RECORDSl\.RE
13, 0 IN POOR CONDmON
14, 0 VITAL (Essential to operations)
15, )( OFFlCIAL COPIES
16a NAlI1E OF PERSON COMPLETING FORM
R( r ~ \t '"t~J
New Yark Slale llTch,v
o Electronic
o llems: N l~
o Monthly
kSeJdOm
Type of icems:
o Never
16b. DATE
"
!
I
,
1
'"\'-\~ '10\
B~J.-
'4t~
GRS2 (12/2002)
9278925 92.J46 CDC