Box 152
Records Inventory Data Worksheet
See InstrUCtions in Publication #76, Invenwry and Planning, before completing this form.
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1a. GOVERNMENT/AGENCY
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2. RECORDS SERIES TITLE
lb. DEPARTMENTIUNIT
Co
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t~~r \)'1 ~\JjL~",>, l)\A~I") C\..-,'W'') \)( 'f\b')lf~\.1~
3. DATE SPAN
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4. RECORDS SERIES DESCRIPTION (Describe cooceoc and characteristics of records)
~ "'1 mt",- n ~,,~ " .\ Q~., b ~ J,,, <''\"\ "'~ '\ \ \)f W ...l( rl '!x '^' ( (
1WL (-(et ~\)t;)'1 Lll~vl\r -:kvtv-,J\>li ~t~~
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fv\ \ ~C~\\L.-.Y'\ ~\J,:> Ct \ l-e) ~'Y\ ~ ~V\ t ~
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5. ARRANGEMENT
o Alphabetical 0 Numerical
o Other (Specify):
6a. RETENUON
o N Ol scheduled 0 Permanent
1 Chronological
o Alphanumeric
o Appraise for hiscorical value
~ Scheduled retention:
\0 y' ~
6b. SCHEDULEJ\ND ITEM NUMBER, ORREASONFORPROPOSEDRETENTION
7. LOCATION C h( '<' .\I"H.....\~
8. FORMAT
~aper 0 Audiovisual 0 Micrographic 0 Electronic
9. TOTAL QU1\NTITY (In cubic feet ornumber of items),
o Cubic feet: ~tems:
10. ANNUAL ACCUMULATION (In cubic feet arnumber of items),
o Cubjcfeet: '~Items:
Type of items:
11. J1REQUENCY OF USE,
o Daily 0 Weekly
12. RESTRICTIONS ON USE
\\j '1\
RECORDS l\RE
13. 0 IN POOR CONDmON
14. 0 VITAL (Essential to operations)
1~ OFFICIAL COPIES
16a NAME ~. PEERRSON COMPLETIN. G FORM.
D~ '-. rv-r.... \) v,t...-V ~
o Monthly
~ Seldom
o Never
16b. DATE
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GRS.2 (12/2002) \\
92.7992592.1~6CDC '15 J--
New Yark State Archives