Box 066
Records Inventory Data V\f orksheet
Sce JrlSLJ'uCLiol1s in PubhciJLlon '1/76, )nvem01Y and Planning, beforc cOfJ)pleung Lhis {ann
lEI.
Ib DEPARTMENT/UNIT
c.i)""'~ 1 f" \\t{
"\ ow '" ~-\
2. RECORDS SERIES TITLE
~ L-"
3. DATESPAN
l ~ " \0
4. RECORDS SERIES DESCRIPTION
(Describe comenL and chanlclerislics of records)
? ley' \\
~\J \\~\
~ ( L i) l \ ') \ 11 ~ l ~ I \ ~J ~ \
~( L~j ~) C\ 6' ~ ~
5. ARRANGEMENT
o Alpbabetical 0 Numerical
~chronOJOgiCal
o Alpbanumeric
o Other (Specify)
6a. RETENTj~N
o NOl scheduled 0 Permanem
~SCbeduled retention:
o Appraise for historjcal vaJue
s S ~\ ~
6b SCHEDULE AND ITEM NUMBER, ORREASONFORPROPOSEDRETENTION
\'is
7. LOCA nON (~
\.--k~ '" w ~i ~ ~
B FORMAT
y;;, Paper 0 AuctJOvisual 0 Micrographic 0 Electronic
9. TOTAL QUANTITY (In cubic feeL or number of iLems),
~ CubiC feet: 0 Items:
10. ANNUAL ACCUMULATION [In cubic feel arnumber of items),
~CUbIC feet: 0 hems:
11 .FREQUENCY OF USE,
o Daily 0 Weekly 0 Momhly Seldom
12 RESTRlCTIONS ON USE
Type of ilems:
o Never
~\t\
RECORDS ARE
13. 0 IN POOR CONDITlON
14 0 VITAL (Essential La operaLlons)
15. ;i.. OFFJCLAL COPIES
16a NAl F PERSON COJvfPLETINC F01
16b. DATE
li:- y~ ~~
Bu)f
~I
GRS.2 (12/2002)
92.709:2592.,.6 CDC