Box 22
Records Inventory Data Worksheet
See IflstrucLlons in Publication t/76, ]nVenLDfY and Planning, IJe[ore completing tillS form.
{~
la. GOVERNMENT/AGENCY lb. DEPARTMENT/UNIT
<- . ("If . 1 /l~' ~) .. '(1?:-t2. Ii ,,'" E <,~' Ck
i,! ,
[ t l~~ \. 'Jf1 r I II '-,J:- c.. - .,.)J .":;'J
2, RECORDS SERIES TITLE
!\",c- ~"<'" r \ E ,.....,.... r-C L-1-
. j../ t::.- j ,/" ~ f., .I
3, DATE SPAN
I C)(J ')
4. RECORDS SERlES DESCRIPTION (Describe content and characteristics of records)
1(' (, '-: /i-.J A f- -rAy. ')
, ; : J r~CL1_
5. ~GEMENT
[lfAJphabetical o Nu.merical o Chronological o AJphanumeric
o Other (Specify):
6a. RETENTION
o NO[ scheduled ~flermanent o Appraise 1'0,1' historical value
o Scheduled retention:
6b. SCHEDULE AND ITEM NUMBER, ORREl\SON.FORPROPOSEDRETENTION
~r -j<j 'l J
7. LOCATION
(' III':' /'- I h.' Ii TH
8. FORMAT
gPaper o Audiovisual o Micrographic o Electronic
9. TOTAL QUANTITY (In cubic feet ornumber of items),
o Cubic feet: ~ms: I Type of items:
10. ANNUAL ACCUMULATION (In cubic feet 01' number of items),
o Cubic feet: 9'Irems: I /~I
11. JlREQUENCY OF USE,
o Daily o Weekly o Monthly ~dom o Never
12. RESTRICTIONS ON USE
I -
I"- ~' J'-. L
RECORDS ARE
13. o IN POOR CO NOm ON
14. o VITAL (Essemialw operations)
15. I2"'OFFlClAL COPlES
16a. NAME OF PERSON COMPLETING FORM 16b. DATE
\. 1\ /<1<(1) . I ( hl~'tLL IOI{)~/Dj
A..
v
New Yark State /Irclllves
GRS-2 (12/2002)
92-7ans 92.146 CDC