Box 079
Records Inventory Data V\( orkshe8t
Sce irlsllUclIOllS in PubliciJlion4176, ]nv!:f)[{JfY and PJar/(Jin!J, beforc cornpJclin!]liJis I'onn
Ib DEPARTMENT/UNIT
W ~ ~'\"') ( r
1 El:-GOVlm.NMENT! AGBNCY
'\ ~\N{\ ~-\
2, REC.f\illS SERIES TITLE
'X \---" \,~ \ \
3. DATE SPAN
\C\\~ - \~l)
4, RECORDS SERIES DESCIUPTION (Describe comcnt CJnd chanlcteristics of records)
~L-y~\\
~ ChronoJogical
5, ARRANGEMENT
o AJphabe[ical 0 Numencal
o Other (Specify)
6a RETENTION
.
o NOl scl1cduled 0 Permanem 0 Appraise for hiSW[Jcal value
~ Scbeduled retention: S - '
6b SCHEDULEAND "EM ~ER, ~SJ;OR~ROPOSEDRETENJ1DN
o AJphanumeric
~~\~
I' 7. LOCATION (
V~{Y\V\J' 1 \~
8. FORMAT
~ Paper 0 Audiovisual 0 Micrographic 0 EJectronic
g, ToTl\L QUANTITY (In cubiC feet oJnumber of ilcms),
~ Cubic feet 0 Items:
10. AJIJNUAl, ACCUMULATION (lIJ cubiC feet ill' number of items),
~ CubIC feet: 0 hems:
11 JTREQUENCY QPUSE,
o Dady 0 Weekly 0 Monthly
]2, RESTRICTIONS ON USE
lJ)f\
RECORDS ARE
13. 0 IN POOR CONDITJoN
14. 0 VITAL (EssemialLO opera lions)
15, ~ OFFJCLAL COPIES
15a NAME OF PERS COMPLETING FORM
D U,,~
New York Slale J\rchives
(,0'11\01)((
~t)~
Type of items:
o Never
16b. DATE
Ll- <"~ ": (J~
~()'xif
)1)
crZS.2 (1212002)
92-70a:l592.1<16CDC