Box 058
t;~
Records Inventory Data V,!orkshe8t
S8C IflSCJ'UCllOI1S in PubliciJCion '1176, Jnvcf)L'(}fY and Plaum{)g bef 01'8 cornpJelin,C) clJis form,
JEL GOVERNMENT/AGENCY
Ib DBPARTMTINT/UNIT
Ci)""~ 1 f" \ \ t(
2 RB:~~~S~~\ ~:~~~:{
3, DATESP~\) '0~ ~ \) ~ \
t, RECORDS SERlESDESCRIPTION (Describe COnLem emu clJal'acterisLics of records)
~ ~ '1 f" \ \ i( t L~ I ~ '>
~~\)LLt/~
5, ARRANGEMENT
o Alphabecical 0 Numerical
'~chronOJ09iCal
o AJpbanumerjc
o Other (Specify)
6a. RETENTlqi'}
o NO[ scheduled 0 Permanem
'i Scbeduled r!;temioo;
o Appraise for hiswncal value
S S "II ~
6b SCHEDlILEAND ITEM NUMBER, QRKEASON.FORPRDPOSEDRETENTION
~"-l S
7. LOCATION ~
I Ck-{'''W~l~~
8. FORMAT
'A Paper 0 Audiovisual 0 Micrographic 0 EJeClronic
9. TOTJ\L QUANDT'{ (In cubic feel or number of iLCms),
'~ CUDIC feeL 0 Items,
10 ANNUAL ACCUMULATION [In cubic feeL ar number of iLems),
~CUbiC feeL 0 hems:
11 FREQUENCY OF USE,
o Daily 0 Weekly 0 MOnLhly Seldom
12, RESTRlCTlONS ON USE
I '~\1\
jRECORDS ARE
13 0 IN POOR CONDITJON
14, 0 VITAL (EssenLiallO operaLions)
15. ';;< OFFJClAL COPIES
16a NAJ F PERSON COJvfPLETING FORN
~ , DN-Iv~ 1\
Type of iLems:
o Never
16b, DATE
l{)'1)(j~
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CrzS-2 (1212002) C; '\
92-700:2592-'.6CDC r L