Box 086
Records Inventory Data \1\7 orksheet
Se!': instructions in Publicmioll 1/76. lnvenwrl' and Planning. before completillfJ this form.
16, GOVERNMENT/AGENCY
lb. DEPARTMENTIUNIT
2.
3. DATESPAN
2007
4. RECORDS SERIES DESCRIPTION (DescrilJe comem ell tel cl Jarelcteristics of records)
ChecK -"Disbursements
Oi)04JOB~"~01/0!J (fOO7J
5. ARRANGEMENT
CJ Alphabetical 0 Numerical
~hronolOgiCaJ
o Alphanumeric
o Uther (Specify):
6a RElENTION
CJ Not scheduled 0 Permanent 0 Appraise for historical value
.~cheduled retention: ~ y .ea ('5
6b. SCHEDULE AND I'IEMNUMBER, OR REASON FOR PROPOSED RETENTION
[245J
7. LOCATION
Clirnwr~H,
B. FORMAT
.~aper 0 Audiovisual 0 Micrographic 0 Electronic
9. TOTAL QUANTl'IY (In cubic feet or number of items):
)((;ubiC feet: L..... I 0 Items:
10. ANNUALACCUMULATlON (In cubic feel ornumber of items):
)(CubiC feet: < 0 Items:
11 FREQUENCY OF USE: .~
o Daily 0 \1\1 eekly 0 Monthly~Seldom
12. RESTRICTIONS ON USE
tJjA
RECORDS ARE
13. :J IN POOR CONDmON
]4. ~CJ}fIT AL (Essential to operations)
15. .~ OFFICIAL COPlES
16a NAME OF PERSON COMPLETING FORM
u..
~
Type of items:
:J Never
16b. DATE
(p tt 0'1
GRS.2 (12.'2002)
92.7992592.146 coe