Box 149
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Records Inventory Data Worksheet
See Jnscrunions In Publication #76, Inventory and Plannmg, before compleling this form.
la GOVERNMENT/AGENCY
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2. RECORDS SERIES TI11.E
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3. DATESPAN
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lb. DEPARTMENTIUNIT
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4. RECORDS SERJES DESCRJPTION (Describe content and characteristics of records)
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5, ARRANGEMENT
o Alphabetical
o Alphanumeric
o Chronological
o Numerical
o Other (Specify):
6a RETENTION
o NO[ scheduled 0 Permanent
o Appraise for historical value
~ Scheduled retention: t \y
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6b. SCHEDULEAND ITEM NUMBER, ORREASON.FORPRQPOSEDRETENTlON
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7. LOCATION
8. FORMAT
~aper 0 Audiovisual 0 Micrographic 0 Electronic
9. TOTAL QUl\NTITY (In cubic feel or number of items).
o Cubic feet: ~tems:
10. ANNUAL ACCUMULA110N (In cubic feet arnumber of items),
o Cubjcfeet: '>4,Items:
11. J1REQUENCY OF USE,
o Daily 0 Weekly
12. RES1RICTIONS ON USE
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RECORDS ARE
13. 0 IN POOR CONDmON
14.0 VITAL (Essential to operations)
15. )4 OFFICIAL COPIES
Type of items:
~ Seldom
o Never
o Monthly
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16b. DATE
16a NAME~PERSON COMPLETIN, G FORM
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GRS.2 (12/2002)
927992592.1"6 CDC
New York Stare Archives