Box 090
~
Records Inventory Data \/\T orksheet
See instructions ill PublicatjOl I 4i7G, lnvenwrl' and Plan rung, before cOlllpletinfl this form.
1El. GOVERNMENT/AGENCY
lb. DEP ARTMENTIUNIT
A ccol.lnh 11
3. DATESPAN
2007
4. RECORDS SERlES DESCRIPTION (Describe comem and cI wracterisLics of records J
~hecK ])js6ursemerrts
12/7}07- O;J07joZ 2007
~J3)
5. ARR.ANGEMENT
[) Alphabetical 0 Numerical
Chronological
[) Alphanumeric
[) Other (Specify):
6a RETENTION
[) Not scheduled [) Permanent 0 Appraise for historical value
'~chedu]ed retention: io yea. rs
6b. SCHEDULE AND ITBMNUMBER, OR REASON FOR PROPOSED RETENTION
[245J
7. LOCATION
Ca y Yl wcd.h
B',!?}MAT
j(paper 0 Audiovisual 0 MicrographIc
9. TOTAL QUANTITY (In cubic feel or number of items):
)(CubiC feet: " I 0 Items:
10. ANNUAL ACCUMULATION (In cubic feel ornumber of items):
. ~biC feet: < , 0 Items:
11 FREQlJENCY'OFUSE,
[) Daily [) VVeekly [) Monthly
:l2. RESTRICTIONS ON USE
o Electronic
Type of items,
)(Seldom
:I Never
Nit
RECORDS ARE
13. [) IN POOR CONDmON
14. \..[)~AL (Essential to operations)
15. ~ OFFICIAL COPlES
16a NAME OF PERSON COMPLETING FORM
16b. DATE
~~WM&k
(p Lj 09
Nell\' York State I\rchive
GRS-2 (12'2002)
92-799:1592.145 CDC