Box 074
~~
Records Inventory Data V\forkshe8t
S88 1(ISLluccio1lS in PubliciJLiofJ '1176, JfJVf:IJWfjl and PJaun)n[j, before cornplt:lin,9this form.
/18
I
12.
GOVERNMENT/AGENCY
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RECORDS SERIES TITLE
lb.
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DEP ARTMTINTIUNIT
cu",,~ 1r. \\l(
3, DATE SPAN
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4, RECORDS SERIES DESCRIPTION (D escribe conLenl ,md clJaI'scteristics of records)
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5 ARRANGEtvrENT
o Alphabe[lcal 0 Numerical
o Ocher (Specify)
~ Chronological
o AJphanumeric
6a. RETENTJ RN
o Not scheduled 0 Permanem
"I<. Scheduled retention;
o Appralse for historical value
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I 6b. SCHEDULE AND ITEM NUMBER, ORREASONFORPROPOSEDRETENTION
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7, LOCATION iJ
\.--k-{ y\ W ,,) ~ ~
8. PORMAT
'A Paper 0 AudJOvlsual 0 Micrographic 0 EleCtronic
9. TOTl\L QUANTITY (In cubicfeel ornumber of iwms},
'){ CubIc feel; 0 Items:
10. ANNUAL ACCUMULATION On cubic feet aT' number of jlems),
1;CUbiC feet: 0 Items:
11 J7REQUENCY OF USE,
o Daily 0 Weekly 0 Monthly Seldom
12 RESTRICTIONS ON USE
~\1\
RECORDS ARE
13 0 IN POOR CONDITION
14, 0 VITAL (EssenLial to operations)
15. 'Ji.. OFFJCLAL COPIES
16a. NAJ F PERSON COMPLETING PORN
Type of items:
o Never
GRS.2 (12/2002)
92.799:15 92.IQ6 CDC
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16b. DATE
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