Box 083
Records Inventory Data V\!orJcsheet
S8C IflSlIUCLiollS in PubllCiJLi(JfJ '//76, JnvC'()wry Clnd PJannin!j, before cOfllpJl,lirlg thiS form.
JEL GOVERNMENT/AGENCY
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2. RECORDS SERJES TITLE
Jb D13PARTMTINTIUNJT
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3. D!\TE SPAN
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~ RECORDS SBRlESDBSCRlPTlON (Describe concenL iJnd ciJa,'ocle)'JsLics of records)
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5, ARRANGEMENT
o Alphabecical 0 Numencal
o Ocher (Specify):
6a. RETENTj('.lN
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o Nm scheduled 0 Permanent O.A pprajse for hlscor]cal value
ji, Sc1ed,led w"mlce S ':) "l \ ';,
.~ ChronoJogical
o AJphanumeric
6b SCHEDULE AND ITEM NUlYffiER, ORREASON PaR PROPOSEDRETENJl ON
7. LOCATION
8. PORMAT
~ Paper 0 AudJOvisual 0 Micrographic 0 EleCtronic
9. TOTAL QUANTITY (In cubic feel oJnumber of i[(oms),
~ Cubic feel; 0 Items:
10. ANNUAl, ACCUMULATION (In cubic feel QT number of ilems),
'a( Cubic feel; 0 he:ms;
11. JlREQUBNCY OF USE,
o Dad)' 0 We:ekJy 0 Monchly
12 RESTRICTIONS ON USE
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RECORDS hRE
13. 0 IN POOR CONDJTJON
14. 0 VITAL (Esse:nLiallO opera lions)
J5. ~ OFFJCw., COPIES
16a. NAME OF PERSO COMPLETING FOlTh!
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Type: of Ilems
o Ne:ver
16b. DATE
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