Records Inventory Sheet
Records Inventory Data V\T ork.sheet
;0101-; I/lSL/'UClIU/l" 1I1 j--'uLJliUJLlUf,-II7G, JIJVCIJWrV CJwJ 1"12111111119, IJtdurr' clJ/lJpleLifJil Lill', funH.
r la -C-6VERNMEN1; AGENCY .------
1~2: ~ RECORDSSEillE"T1TLE
lb. DEPARTMENT/UNIT
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l"llATESf'M
4. RECORDS SERIES DESCRIPTION (Dcscr-iLH: cuilLefll alld characLensLic5 01 ['c/cords)
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15. ARHANGEMENT
o f~Jphabetical o Numerical o Chronological o Alphanumeric
o Other (Specify):
6a RETENTlON
o NOL scheduled o Permanent o Appraise for historical value
o Scheduled retention:
6b. SCHEDULEJ\ND ITEM NUMBER., OP,REASON.FORPROPOSEDRETENTION
7. LOCATION
8. FORMAT
o Paper o Audiovisual o JVjicrograplllc o ElecLroruc
9. TOTAL QUANTm' (lncublc feel or number of items),
o Cubic feeL: o hems: Type of ll:ems:
10. ANNUAL ACCUMULATION (in cubiC feel ornumber of llems),
o Cubic feeL: o ltems:
11. I1lliQUENCY OF USE:
I o Daily o Weekly o Momhly o Seldom o Never
12. RESTRICTIONS ON USE
RECORDS ARE
IJ3. o IN POOR CONDrrJON
114. o VITAL (Essenmli to operations)
115. o OFFJCLAL COPIES
116a NAME OF PERSON COMFLETD'-lG FORM
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16b. DATE
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GP5 2 (12/2002)
9J.7D92:'J 92-\46 CDC
New Yorl: Stale hrch,ves