Box 159
Records Inventory Data Worksheet
See Instructions in Publication #76, Invenwry and Planning, before completing this form.
lb. DEPARTMENTIUNIT .\..
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la. GOVERNMENT/AGENCY
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2. RECORDS SERIES TITLE
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3. DATE SPAN
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4. RECORDS SERIES DESCRIPTION (Describe content and characteristics of records)
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5, ARRANGEMENT
o Alphabetical 0 Numerical
~ Chronological
o Alphanumeric
o Other (Specify):
6a. RETENTION
o NO[ scheduled 0 Permanent 0 Appraise for historical value
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6b. SCHEDlILEJ\ND ITEM NUMBER, ORREASONFORPROPOSEDRETENTION
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7. LOCATION
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B. PORMA T
~Paper 0 Audiovisual 0 Micrographic 0 Electronic
9. TOTl\LQUJ\NTITY (In cubic feet or number of items).
o Cubic feet: J(hems:
10. ANNUAL ACClJMULATION (In cubic feet arnumber of items),
o Cubic feet:
11. .EREQUENCY QP USE,
o Daily 0 Weekly
12. RESTRICTIONS ON USE
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RECORDS ARE
13. 0 IN POOR CONDmON
14. 0 VITAL (Essential to operations)
15. ~ OFFlClAL COPIES
16a. NAME ;:-.PERSO~ COMPLETING FORM
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New York State Archives
ems:
o Monthly
Seldom
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Type of items:
o Never
16b. DATE
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GRS.2 (1212002)
92-7992592146 COC