Box 24
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Records Inventory Data Worksheet c---
See instructions in Publication 1/76, }nvenwry i:1IJd Planning, before completing this form.
la. GOVERNMENT/AGENCY lb. DEPARTMENT/UNIT
IllU;rJ cF Wl\ fr / jlJt &e j\5S 05S(.{2
2. RECORDS SERIES TITLE
" A 'f.. G- Y-. ~ 1'-1 PT I 00
3. DATESPi\N
j (1 (1 (1 ~ ,.2 60 J
4. RECORDS SERIES DESCRIPTION (Describe content and characteristics of records)
f>A S Ie S TAi2 6- y... el\,,\ P -n 6 f;.J :; M-N
6. ARRANGEMENT
IDJphabeticaJ . 0 Nuft)erical o Chronological o AJphanumeric
o Other (Specify):
6a RETENTION
IVNDt scheduled o Permanem o Appraise for historical value
o Scheduled retention:
U '-J r::::~) f\ F , t-12 <; fA f2. E'f-. E:-1'-1PTION I ') ;\JQ 1.-0 N (;' t:C (J P F E RSJ)
6b. SCHEDULE AND ITEM NUMBER, ORREASON.FORPROPOSEDRETENTION
II. [)~q]
7. LOCATION
C A(!",0 WA TH
8. FORMAT
~aper o AudlOvisual o Micrographic o Electronic
9. TOTAL QUANTITY (In cubic feel or number of items),
~ubic feet: I o Items: Type of items:
10. ANNUAL ACCUMULATION (In cubic feet or number of jtems),
~Cubic feet: 1/ J .'~ o Items:
11. JlREQUENCY OF USE,
o Daily o Weekly o Monthly ~eldom o Never
12. RESTRICTIONS ON USE
A ,/' -- /? .., STAFF C'N L'I
<)')'t:;:..:"/L,/Ch
RECORDS ARE
13. o IN POOR CONDmON
14. ~AL (Essemialto operations)
15. o OFFIClAL COPIES
16a NAME OF PERSON COMPLETING FORM 1Gb. DATE
L/ILtlH..e J.r .t- Chl/;LL ( IO!vf!(A
New York State Ilrd(,ves GRS-2 (12/2002)
92.7QD25 92-'.6 COC