Box 25
Records Inventory Data Worksheet
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See instructions in Publication //76, ]nVenLDiY CJnd Planning, IJe[ore cornpletin!] this forrn, ~/ /
, la. GOVERNMENT/AGENCY lb. DEPARTMENT/UNIT / I
/0 t/v' tJ OF vJA pp i }.) G (;,1<. ASS cS5c:;{<.
2, RECORDS SERIES TITLE
IA'i- ~ 'f- E:.Me T}00
3. DATE SPAN
i C1 q l' - ,266/
4. RECORDS SERIES DESCRIPTION (Describe content and characteristics of' records)
6,L\SiC. S 'TA-f2 b-~&I-1PTI Ot-JS o-R.
5. ~EMENT
Alphabetical ': o Numerical o Chronological , 0 Alphanumeric
o Other (Specify);
6a RETENTION
~O[ scheduled o Permanent o Appraise for hiswrical value
o Scheduled retention:
~" j{~' (t. .f+e ( STAR. -lV.(: rn ett' D () 15 t'lD J C'f\9'~,r Oft erf'cI
6b. SCHEDULEAND ITEM NUMBER, ORREASONFORFROPOSEDRETENTlON
I L {)~'-11
7. LOCATION
CA~/,htjA TI-\
B. FURMAT
~per o Audiovisual o Micrographic o Electronic
g, TOTAL QUl\NTITY (In cubic [eel ornumber of items),
Q'(ubic feet: I o Items: Type of ilems:
10. ANNUAL ACCUMULATION (In cubic feet or number of items),
Ila'tubic feel: I / ~,.' o Items;
11. .EREQUENCY OF USE,
o Daily o Weekly o Monthly ~eldom o Never
12. RESTRICTIONS ON USE
ASS e:5Sc'(;::: 5TA r F DN L.'I
RECORDS ARE
13. o 1N POOR CONDmON
14. ~AL (EssentialLO operations)
15. o OFFICIAL COPIES
16a NAME OF PERSON COMPLETING FORM 16b. DATE
l/1Laiu.>r ~,UJUflLI' IO/()&/IJ~
New York State IIrchives
GRS-2 (12/2002)
92-7002592-146 CDC