Box 084
Records Inventory Data V,! orkshe8t
See IflselUCLIOllS in PubliciJCiofl '1/76, JnVf:IJWfj1 C1ud PJal/(JJ{}y, bcf 01'8 cornpl8c'lng chiS rOmL
18 GOVERNMENT/AGENCY
Ib DBPARTMTINT/UNJT
C.U ""~ 1 J" \ \ tf
\' Q\J0 If' ~ ~ \;::h,. R Q\'^~ c (
~ RECORD~S:,"s m:\ \ 'J ~
3, DATESPAN \ ~ I 'c _. \ C\C'(J
4, RECORDS SERIES DESCRIPTION (Describe concent 2wd cl)81'21cteristics of records)
~ l- '1)\ ~ \\
5 ARRANGEMENT
o Alphabecical 0 Numencal
o Other (Specify)
I 6a. RETENTJqN
I 0 Noc scheduled 0 Permanent 0 Appraise for his[Qf)cal v8Jue
'jscheduled retemlon- ./
i~~l) ~
, 6b SCHEDULE AND ITEM NUlv!EER, ORREASON.FORPROPOSEDRETENTION
'~ChrOnOJ09iCal
o Alph8numeric
~~s
7, LOCATION (~, \
"---' k -{ Y'\ W h.l ~ ~
8, FORMAT
"APaper 0 AudJOvisual 0 Micrographic 0 EleCtronic
g, TOTJ\.L QUl\NTITY (In cubic feee OJ number of iL8ms),
'){, Cubic feel 0 Items:
10 ANNUAL ACCUMULATION (In cubic feet or number of items).
1:; Cubjc feee: 0 Icems:
11 J7R.EQUENCY OF USE,
o Dady 0 WeekJy 0 Monch1y Seldom
I
12, RESTRICTIONS ON USE
Type of ieems:
o Never
\'J\"
RECORDS J\RE
13 0 IN POOR CONDITJON
14 0 VITAL (EssenLial co operaClons)
15, '-Y;< OFFJCLAL COPIES
163. NAJ F PERSON COMPLETING FORM
~, DWvv 1\
Gn.s 2 (12120021
92.7DaLS 92.,.6 CDC
OSllxf
15
16b DATE
y" \-} ", ~t