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Box 089 Records lnventory Data "\N orksheet See immuclions in Publication t/76. lnvenwf:I' and PlafJnin9. before completillfllhis fornl. la. GOVERNMENT/AGENCY lb. DEPARTMENT/UNIT .--r;w.'\ of Wo...OO" (jCle(' Accounti .'14 .2. RECORDS SERIES TITLE v ~. 3, DATE SPAN 2007 4- RECORDS SERlES DESCRIPTION (Describe comem alld characlenslics of records) c'h e c. k. "1) i 5 burs e m e. nts (ia?; /D)Jr:;!07- II}Z 1/07 20D7 5. ~GEMENT .~hronolOgiCal =:J Alphabetical o Numerical o Alphanumeric :J Other (Specify): 6a RE'IENTlON Q Not scheduled Q Permanent Q Appraise for historical value >>cheduled retention: h years 6b. SCHEDULE AND ITEMNUMBER, OR REASON FOR PROPOSED RETBNTION [z4SJ 7. LOCATION c..aYI1WQ;!-h B'Z:T . Paper Q Audiovisual o Micrographic o Electronic 9. TOTAL QUANTITY (in cubic feet arnumber of items): X'CubiC feet: ~I o Items: Type of items: 10. ANNUAL ACCUMULATION (In cubic feet arnumber of items): )(CubiC feet: ~ 1 o Items: 11 FREQ1JENCYOF USE, )(Seldom o Daily o "\leekl)' o Monthly :J Never 1.2. RES1RlCTIONS ON USE tJik -- RECORDS ARE CSO~ ') 13. 0 IN POOR CONDITION 14. Q VITAL (Essential to operations) '6~..... 15. XOFFIClAL COPIES 16a NAME OF PERSON COMPLETING FORM 16b. DATE O'\~ 67~Gl-\~ (PJ~J01 New York State Arcll,ves GRS-2 (12.'2002) 92-7992592.146 CDC