Box 12
Records lnventOIjT Data VV orksheet
Sl"! IIISlrUCLlOIlS if I Publicmj(JfII176, }f1V()f1WI)' Clnd PlaIJning, IJefo)'{c cOfllpJelin,lj tllis form.
la. GOVERNMENT/AGENCY lb. DEPARTMENT/UNIT
"i (;LcIC') of k),:J I? I ,Je,-GJ2. ASS2S5x:.~t2.
2, RECORDS SERIES TffLE
'I A 'I t:; X E V~ 1 e I ( o~J
3, DATESPAN
r, , /\ (
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4, RECORDS SERIESDESCRJPTION (Describe content and characteristics of records)
f' A'" .
I,) ':.:) / C.
~) TAl~ G>CCnle IJ C:f.-'
Arr7L J C I1T/O~:S
L It;;.. 1---; I ED
G Y- t:- /v1 e TIC f-.-) fl f'FJ LIe ;-) T J () 1--:' S
6, ARJlANGEMENT
Ill'AJphabeticaJ 0 Numerical
o Other (Specify):
6a RE}'ENTION
IitNm scheduled 0 Permanent
o Chronological
o Alphanumeric
o Appraise for historical value
o Scheduled retention:
((. ~ 1'5 ((:0 J ( r ~1>',:. J'y.,~llu p f> c; {) I> )) (. I () I i,/' I (t( 11 ,-./ d
6b. SCHEDULE AND ITEM NUMBER, OR.REl\SON.FORFROPOSEDRETENTION
J L L 5' ~ LI ]
7, LOCATION
C 1\ f?- f0 V_I ATH
8, FORMAT
~per
o Audiovisual
o Micrographic
o Electronic
g, TOTAL QUANIITY (1n cubic feet or number of j terns),
r;;rtubic feet: 0 Items:
10. ANNUAL ACCUMULATION (1n cubic feet ol'number of items),
Grt:Jbic fe8t: l. ( 0 Items:
11. J7REQUENCY OF USE,
o Daily 0 Weekly 0 Monthly ~dom
12, RESTRICTiONS ON USE
A ~s E>~Sc) I~ S -r A F F c';j\..h./'f
RECORDS ARE
13, 0 IN POOR CONDITJON
14, ILI4ITAL (Essential to operations)
16. 0 OFFICIAL COPIES
16a. NAME OF PERSON COMPLETING FORM
L /L t?k e.~ ~t-. U)l-1-<-U
New York State Jlrchives
Type of items:
o Never
16b. DATE
:),( ~
/ (.
c...,.. -..>
GRS2 (12/2002)
92-7992592-1"16 coe