Box 068
Records Inventory Data V\!orksheet
See irlSLiuCLIol1S in Publicmiorl '//76, )nvenwlY and Plaoninv, b8[ol'e completing LiJIS ramI.
GOVERNMENT/AGENCY lb.
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2 RECORDS SERlES TIT~ \f\) J
L-. ~ ~ \ \
3. DATESPAN \ ~ ~ \.
4. RECORDS SERIES DBSCIUPTION
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DTIP AR TMTINTIUNIT
G \) """t iJ~ \)C(
(Describe content CJnd Ch3l'sclc:rislics of records)
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5, ARRANGEMENT
o AJphsbwcal
o Numerical
'AChrOnOJOgiCal
o Alphanumeric
o Other (Specify}
6a. RETENTION
I
o Not scheduled 0 Permanem
~heduled retention
o AppraJse for historical value
SS"i>
6b SCHEDlILEAND ITEM NUMBER, QRREASON.PORPRDPOSEDRETENTION
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7. LOCATION f. " \
~~1 {\ 'v~ LJ ,. ~
o Audwvisual 0 Micrographic 0 Electronic
9. TO J\L QUANTITY (In cubiC feet ornumber of Jlems),
~ CubiC feel 0 Items:
10 ANNUAL ACCUMULATION (In cubiC feel ar number of items),
~ CubiC feel: 0 hems:
11 J1REQUENCY OF USE,
D Daily 0 Weekly 0 Momhly
12. RESTRiCTIONS ON USE
\\.\ '~
Type of items:
o Never
New York Slace )\rcliivcs
GRS.2 (12/2002)
92.799:2592.146 CDC
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* 1/3
16b. DATE
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