Box 137
Records Inventory Data V\T orJcsheer
Sec ifJS[JUCLiollS ir! PubliCiJ,iOfJ '/176, )nvf!nwry Clnd PlaJ'J{Jf(Ji}, bcfote completing ,his form,
"-131
3, DATE SPAN
Jb DEPARTMENT/UNIT
~ \; \,.j v, r l;\AL. ( r
2 RECORDS SERIES TITLE ~ ~
~ '" (\) \ \ ~ 1>\)!'v\~~
t \) ~ \) \,\,- ~\)()l
la, GOVERNMENT/AGENCY
"\ \) \l~{\
GO"iL\)(f
-s ~'^ ~~~\.
4, RECORDS SERlBSDESCRIPTLON (Describe coment iJnd CIHl,'scteristics or records)
~f.,:'I(\)\\ ~W~"'~ 3..", ~~\)'\
\~ ~ \)y\ '- ~~ () I
5, ARRANGEMENT
o AlpbabeElcaJ 0 Numencal
'~ Chronological
D Alphanumeric
D Other (Specify);
6a. RETENTIC1N
~
D Not scheduJed 0 Permanem
~ Scheduled retention
o Appraise for hJswrjca) value
6b SCHEDULE AND ITEM NUMBER, ORRElI.SON FORPROFOSEDRETENTIDN
\~
s S 'i-t~J ~
7, LOCATION
1\~
8, FORMAT
)(i Paper D AudJOvisual D Micrographic D Electronic
9, TOT7I.L QUANTITY (In cubic feet ornumber of iLCms),
~ Cubic reet 0 Items:
10 ANNUAL ACCUMULATION (In cubic feet ar number of items),
~ Cubic J eet: 01Lems:
11 J1REQUENCY OF USE,
D Daily 0 Weekly 0 Monthly
]2, RESTRiCTIONS ON USE
lJ: 1\
RECORDS ARE
13, D IN POOR CONDITJON
1':}, 0 VITAl (Essemial to operations)
15, ~ OFFJCLAL COPJES
16a NAME OF PERS COMPLETING FORN
I D IJvv~
Type of ILems:
o Never
~ Cix4
16b DATE
New Y6r1: Scace hrclllVes
\ \.. \~.. \)~
t b-.JY
GTZS-2 (J2I2002)
92-790:2592,,. 6 cae