Box 055
18 GOVERNMENT/AGENCY
\' iJ\,v'", \) ~
2, RECORDS SERIES TITLE
9 h", \'J \\
3, DATE SPAN
\ <\C\<\
Wk~ ~\.f\~ ({
\(('l()~\~
Ib DEPARTMENT/UNIT
CO "^'~ ll\, \1 t{
Records Inventory Data Vlorkshe8t
S8e IflSLJUCUCJllS in PubliCiJLiofl.j/76, )nvcflWfjl aiJd PJiJiJ{JJn!J, befo}'8 completing chiS [ann
4, RECORDS SERlESDESCRlFTION (Describe concenr emu Chill'scteristics of records)
\1\(\ '\ ~ "'{" \ \ ~ll.. "j~ )
5, ARRANGEMENT
o AJjJhabcncal 0 Numencal
o Other (Specify):
~Chr0J10J09iCal
o AJphilnumerjc
63. RETENTJqN
o Not scheduled 0 Permanem
~ Sclleduled fI:temion
o Appraise for nislOncal value
S~y')
6b SCHEDULE AND ITEM NUJv1BER, ORREASONFDRPROPOSEDRETENTION
7 LOCATION (~ ,
"--'h.-{Yj w ~ll \
8. FORMAT
"APaper 0 Audiovisual 0 Micrographic 0 Electronic
9. TOTAL QUl\N11TY (In cubic feel oFnumber of iecms),
~ Cubic feel 0 Items:
JO. ANNUAL ACCUMULATJON (In cubic feeL arnumber of iLems)
~Cubjcfeel: 0 lLems:
11 JlREQUENCY OF USE,
o Daily 0 Weekly 0 MOnLhJy Seldom
12 RES1RlCTlONS ON USE
~\t\
RECORDS ARE
13, 0 IN POOR CONDITJON
1'}. 0 VITAL (Essenllal La opera lions)
15. ';;( OFFJClAL COPIES
16a. NAJ F PERSON COJvIPLETING FORM
>-- '\\ ~-\-,
, .L-J lr-.Nv J\
Type of l[ems:
o Never
CTZS-2 (J2/2002)
9.2.7.90'1592-1Q6CDC
~O\1t'
)~
16b. DATE
\.) ,-, l '. iJ \