Inventory Worksheet
Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1a.GOVERNMENTNAME / ~X Of-F ;~~PARTMENT
2. RECORD SERIES TI~ S I
/998'- z9_c-n(),,/ ~x 8i//s
1 c. UNIT
3. SARA SCHEDULE AND ITEM NUMBER f 4. RETENTION PERIOD
oi'j'iiscHEOUi...iN.,,;;;;;;,ii;;;;;,-N;;;;;&;T.........................._...........................-..................../ De s + r 0 y
.NOT.scHEDuL.EO.................................................................................................................................................... c2. 0 {} 5
a. BUILDING b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(From)
BULK DATES
(From)
8. CHARACTERISTICS (Check all that apply)
Paper
Q letter Size
Q legal Size
Q Bound Volumes
, Q Cards
U Computer Printout
Q Maps, Drawings, Plans
Q Other (Specify)
contin1 below
Total Quantity
9.
I ...........................................................1
.
(Cubic FeeV
Contin1 below
10. Annual Accumulation
1............K:-;,;;i~.F;;;;.............-1
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological
o Other (Specifyl........................................................
(To)
Audio-visual
Electronic Records
(Complete Item #17)
Microfilm
Q 16mm Roll Film
Q 35mm Roll Film
Q Microfiche
i:J A.pertu re Cards
CI Other (Specify)
I~
IQ
!Q
Q Audio Tape
Q Videotape
Q Motion Picture
i:J Photo Prints
Q Film Negative
Q Photo-color Slides
o Other (Specifyj
Tape
Hard Disk
Diskette (Floppy Disk)
Optical Disk
Q CD ROM
Q Other (Specify)
Contin~ below
Contin1 below
contin1 below
Total Quantity
Total Quantity
Total Quantity
/
/
(Number of Items)
contin~below
Annual Accumulation
(Rolls) !Items)
contin1 below
Annual Accumulation
(Bytes) (No. of Items)
Contin~ below
Annual Accumulation
/
/
(Number of Items)
(Rolls) (Items)
(Bytes) (No. of Items)
11. OFFICIAL COPY?
Q Yes CI No
HELD BY
12. OTHER COPIES?
Q Yes Q No
I 13. REFERENCE FREQUENCY
Q Daily 0 Seldom
o Weekly 0 Never
Q Monthly
14. POOR CONDITIONl
Q Yes a No
15. RESTRICTED 01' CONF.lpENT!AU
Q Yes a No
U......nn.......................................nn........... ...n.........................
New York State Archives and Records Administration
. COIItinued 011 other fide .
Local Government Records Service!
LGRS-5 (7/95)
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Jnventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
la.GOVERNMENTNAME - 0 r 1'\ lb. DEPARTMENT lc.UNIT
/ a.. X _ III c.~ J
2. RECORD SERIES TinE S I -r- 0 +
Ir99-d...O~~ C-h I fJ / ~)( B i I/s c . /9 - NfJV: /tJ
3. SARA SCHEDULE AND ITEM NUMBER
4. RETENTION PERIOD
De s+:soy
r2 () ()
'OTHER"s(iiEi5i]i:E"iNa;;;;;;'a'n,(iiem'Nu;;;lje~T"""""""''''''''............................................................................
NOT SCHEDULED
a. BUILDING
6. DATE SPAN
(From)
BULK DATES
(From)
8. CHARACTERISTICS (Check all that apply)
Paper
Q Letter Size
Q Legal Size
Q Bound Volumes
Q Cards
Q Computer Printout
Q Maps, Drawings, Plans
::r Other :Specify)
Cantin~ below
9.
Total Quantity
(Cubic Feed
Cantin~ below
10. Annual Accumulation
I ......................................................_...1
(Cubic Feet) ,
b. FLOOR I c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
Q Alphabetical
Q Alphanumeric
Q Numerical Q Chronological
Q Other (SpecifyL.................___...............................
(To)
Audio-visual
Electronic Records
(Complete Item #17)
Q Tape
Q Hard Disk
Q Diskette (Floppy Disk)
::r Optic;:;, = iSK
Q CD ROM
Q Other (Specify)
Microfilm
Q 16mm Roll Film
Q 35mm Roll Film
Q Microfiche
::r Aperture Cards
Q Other (Specify)
Q Audio Tape
Q Videotape
Q Motion Picture
U Photo Prints
Q Film Negative
Q Photo-color Slides
U Other (Specify)
Contin~ below
Contin~ below
conti. below
Total Quantity
Total Quantity
Total Quantity
/
,
!
(Number of Items)
Contin~ below
Annual Accumulation
(R.olIs)
(Items)
(Bytes)
(No. of Items)
contin~ below
Annual Accumulation
Contin~ below
Annual Accumulation
/
/
(Number of Items)
(Rolls) (Items)
(Bytes) (No. of Items)
11. OFFICIAL COPYl
Q Yes Q No
HELD BY
12. OTHE/l COPIESl
Q Yes Q No
I 13. REFERENCE FREQUENCY
Q Daily Q Seldom
Q "Yeek1y Q Never
Q Monthly
14. POOR CONDITION?
Q Yes Q No
15. RESTRICTED flit CONFIDENTlAU
QYes Q No
New York State Archives and Records Administration Local Government Records Service!
'.. -(:nV 1''''' _ .... .. - '. . . .' . . ..... LGRS-5 (7/95)
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Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1 a. GOVERNMENT NAME ---"",EPARTMENT
, CrY..... ~ c."t.--
2. RECORD SERIES TinE l)J
1 c. UNIT
3. SARA
~
5
'OTHEii"SCH"Ei5j]i:E"iNam~'a';:'{jJiem'N;;mb~;T""''''''''''''''''''............................................................................
"J) t-St'r"Dt
;)DDS
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
.------..-.-..-..-..............--.....-.-......--...--.---..--.......--....-....-.--.--....-.....----.-..-...-....................
NOT SCHEDULED
. a. BUILDING
(From)
BULK DATES
(From)
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological
o Other (SpecifyL..___............................_........
(To)
8. CHARACTERISTICS (Check all that apply)
Paper
Audio-visual
Electronic Records
(Complete Item #1 7)
; :J Letter 5 ize
, :J Legal Size
:J Bound Volumes
: ::J Cards
: ::J Computer Printout
, ::J Maps, Drawings, Plans
:J Other (Specify)
CDIltin~ below
9. Total Quantity
I-K~;F;;.:'-.--I
Cootin. below
10. Annual Accumulation
!--rM/;F;;V-/
Microfilm
o 16mm Roll Film
o 35mm Roll Film
Co! Microiiche
a Aperture Cards
o Other (Specify)
I
! Q Tape
I Q Hard Disk
'Q Diskette (Floppy Disk)
U Optical Disk
U CD ROM
I Q Other (Specify)
I
U Audio Tape
U Videotape
U Motion Picture
U Photo Prints
U Film Negative
U Photo-color Slides
U Other (Specify)
Cantin, below
Total Quantity
conrin'f below
contin~ below
Total Quantity
Total Quantity
/
/
(Number af Items)
conrin'f below
Annual Accumulation
(Rolls) (Items)
Contin'f below
Annual Accumulation
(Bytes) (No. of Items)
Cantin, below
Annual Accumulation
/
/
(Number of Items)
(Rolls) (Items)
(Bytes) (No. of Items)
'1. OFFICIAL COPYl
QYes Q No
.HELD BY
13. REFERENCE FREQUENCY
Q Daily 0 Seldom
Q ~eekly 0 ~eve~ .C;;.,
a Monthly "' .
.
14. POOR CONDITIONl
Q Yes Q No
12. OTHER COPIES1
U Yes a No
----_...~.._-_._......__..._..-
,..., ..",,;\:,," .;'
15. RESTRICTED or CONFIDENTIAll
U Yes Q No
.
.. ""New York State Arc:hivelllld Records AdmJnJsIratiOll ,JillI4]tI",f(ll!F~.,~.;"(,,.,..
., x' '.L,-,\(.'t#,;":,lftca' t".nV"'.....,R~ ~
Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
la. GOVERNMENT NAME ~ARTMENT
~
1 c. UNIT
2. RECORD 'ER'ES ~ _
\~C\. VJ '"\ \C(~
3. SARA SCHEDULE AND ITEM NUMBER
--
D'-S'rvo'"j
d..()05
'OiHER's6.j'EoUi:E"iNa;;;~"an;Tiiem'Numbe;j................m....m.............................................................--..........
.iiioy.scHEDuLE'o..-......-.-....--............-.--................_.............._........m........................_............_........
. a. BUILDING
6. DATE SPAN
(From)
BULK DATES
(From)
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
CJ Alphabetical
CJ Alphanumeric
o Numerical 0 Chronological
o Other {Specify)............_........__._............_............
(To)
8. CHARACTERISTICS (Check a/l that apply)
Paper
U Letter Size
U Legal Size
I U Bound Volumes
U Cards
I Q Computer Printout
U Maps, Drawings, Plans
I Q Other (Specify)
continf below
9. Total Quantity
1._..iC;b;:F;.~-...1
contin. below
10. Annual Accumulation
/.--m.----rc;;;;;;.F;;V.----/
Audio-visual
Electronic Records
(Complete Item #17)
U Tape
o Hard Disk
U Diskette (Floppy Disk)
i U Optical Disk
I U CD ROM
! U Other (Specify)
I :~~:::~:~=:=:=:=::~~~~:~~::~::~:~==:=::
I ...............-........................................
Microfilm
Q 16mm Roll Film
Q 35mm Roll Film
Q Microfiche
Q Aperture Cards
U Other (Specify)
U Audio Tape
I U Videotape
: ::i Motion Picture
U Photo Prints
U Film Negative
. Q Photo-color Slides
I
: Q Other (Specify)
.--------....----....-.-..................
continf below
Total Quantity
CDlltin'f below
contin~ below
Total Quantity
Total Quantity
/
/
(Number of Items)
Contin.. below
Annual Accumulation
(Rolls) (Items)
Cantin. below
Annual Accumulation
(Byres) (No. of Items)
Cantin.. below
Annual Accumulation
/
/
(Number of Items)
(Rolls) (Items)
(Bytes) (No. of Items)
11. OFFICIAL COPY?
a Yes U No
HELD BY
13. REFERENCE FREQUENCY
a Daily U Seldom
a \yeek1y a Never
QMonthly
14. POOR CONDITIOM
a Yes U No
12. OTHER COPIES?
U Yes a No
15. RESTRICTED or CONFIDEN'I1AU
ayes a No
"'. ~YOrk state Archives ~ ...... . ';'~,iLj'.
i~'.,I.J[.~;"~~Ai1.~.~,;:>,<,.,~,.,.f . . ..~..",' ~!!!!,!,,' ... ';ik'",;hF ,~~.
NOTE: See accompanying instructions before filling out this form.
1a. GOVERN~T i'oJA~E lb. DEPARTMENT
2. ,ECORD SERIES~ ~ ~" LI\..\ \cc "'-
,
3. SARA SCHEDULE AND ITEM NUMBER
Inventory Worksheet
for Local Government Records
1c.UNIT
~
--r.,. J l )(1e.. - ~O
--
'OTHER"sEj.j'EDui:E'TN~;:;;e":;iicili;;;;:"Nu;;:'be;j"'''''''''''''''''................................................................-..----.........
4. RETENTION PERIOD
NOT SCHEDULED
a. BUILDING
(From)
6. DATE SPAN
BULK DATES
(From)
1;1:sfO~
~coS
b. FLOOR i c. ROOM d. CABINET or SHELF i e. DRAWER or BOX
I
(To)
7. ARRANGEMENT
o Alphabetical
a Alphanumeric
o Numerical 0 Chronological
o Other (SpecifyL.__...............................................
(To)
8. CHARACTERISTICS (Check a/l that apply)
Paper
U Letter Size
::i Legal Size
Q Bound Volumes
::l Cards
: ::, Computer Printout
. ::, Maps, Drawings, Plans
, :;:, Other (Specify)
9.
contin. below
Total Quantity
_____.______1
(Cubic Feet)
Conrin~ below
10. Annual Accumulation
I ----.--...(C;;;;OF.;;v-..-..--/ .
Audio-visual
Electronic Records
(Complete Item #17)
I u Tape
I U Hard Disk
I U Diskette (Floppy Disk)
::: :'orical Disk
! :;:, CD ROM
Q Other (Specify)
Microfilm
U Audio Tape
U Videotape
U Motion Picture
, ::, Photo Prints
CI Film Negative
U Photo-color Slides
CI Other (Specify)
o
::t
i
I~
'::J
j::J
I ....................................-......................
16mm Roll Film
35mm Roll Film
Microfiche
\perture Cards
Other (Specify)
Contin. below
Contin~ below
Contin~ below
Total Quantity
Total Quantity
Total Quantity
/
/
(Number of Items)
cotitin~ below
Annual Accumulation
(Rolls) (Items)
" Contln; below
Annual Accumulation
(Bytes) (No. 0; Items)
conrin~ below'
Annual Accumulation
/
/
(Number of Items)
(Rolls) (Items)
(Bytes) (No. of Items)
'1. OFFICIAL COPY?
.:J Yes Q No
HELD BY
14. POOR CONDITIONl
U Yes 0 No
12. OTHER COPIESl
CI Yes Q No
13. REFERENCE FREQUENCY
.:J Daily 0 Seldom
Q \yeek1y Q Never
Q Monthly
1 S. RESTRICTED or CONFI.DENTIAU
o Yes Q No
New York State Archives and Records Administration
- Con~ 011 DIIter.. -
local Government Records Service!
lGRs..5 (7/95)
I nventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1 a. GOVERNMENT NAME
1 c. UNIT
~ ~~ro\~ '" C f\V\r
~
NTION PERIOD
.OTHER..sc.j:iEouLe"TNaiTi;;.i3.",iii;;m.Numbe;T..................................................................................................
...U~.......h............h_._n.................................n....u........................................................................................................_...
NOT SCHEDULED
~oD5
a. BUILDING
6. DATE SPAN
(From)
BULK DATES
(From)
b. FLOOR c. ROOM d. CABINET or SHElF e. DRAWER or BOX
(To)
7. ARRANGEMENT
a Alphabetical
U Alphanumeric
o Numerical a Chronological
o Other (Specify)...........................................................
(To)
8. CHARACTERISTICS (Check all that apply)
Paper
o Letter Size
o Legal Size
a Bound Volumes
Q Cards
Q Computer Printout
Q Maps, Drawings, Plans
Q Other'5pecify)
9.
contin, below
Total Quantity
(Cubic Feet)
contin, below
10. Annual Accumulation
I--rc;b;-;;;;;---I
Audio-visual
Electronic Records
(Complete Item #17)
o Tape
o Hard Disk
a Diskette (Floppy Disk)
Q Optical Disk
o CD ROM
o Other (Specify)
Microfilm
16mm Roll Film
3Smm Roll Film
Microfiche
Aperture Cards
Other (Specify)
o Audio Tape
o Videotape
o Motion Picture
:r Photo Prints
o Film Negative
o Photo-color Slides
Q Other (Specify)
10
16
:r
Q
Continu~ below
contin, below
contin~ below
Total Quantity
Total Quantity
Total Quantity
/
/
(Number of Items)
contin~ below
Annual Accumulation
(~olls)
(Items)
(Bytes)
(No. of Items)
contin~ below
Annual Accumulation
Contin~ below
Annual Accumulation
/
/
(Number of Items)
(Rolls) (Items)
(Bytes) (No. of Items)
11. OFFICIAL COPYl
o Yes Q No
HELD BY
12. OTHER COPIESl
o Yes CJ No
/13. REFERENCE FREQUENCY
Q Daily 0 Seldom
o Weekly CJ Never
CJ Monthly
14.. POOR CONDITION'
a Yes a No
15. RESTRICTED or CONflDENTlAU
ayes Q No
New York State Archives and Records Administration Local Government Records Servfce!
:::::::-.::::,~~.;;~I'r~..:::~';~S..::_~~.!~'._:1t.._J'il~in..'" "tl.~G~~..
NOTE: See accompanying instructions before filling out this form.
1a.GOVERNMENTNAME 7a. 0 r f.. 1b.DEPARTMENT
X. ;- aCP-
.
S e-h () ~ / Ta..x. tB ,./ /S
Od-, I
Inventory Worksheet
for Local Government Records
1 c. UNIT
3. S
4. RETENTION PERIOD
Desfroy
;2 () 05
'OTHEii"sc'H"EjjULE"iName"a'ii;:r;iem'N~mbe;j"''''''''''''''''''''''''''.......................................................................
NOT SCHEDULED
...................................................................nn.....................................nn........................n_............................................
a. BUILDING
6. DATE SPAN
(From)
BULK DATES
(From)
b. FLOOR ! c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological
o Other (SpecifyL.........................................................
(To)
8. CHARACTERISTICS (Check all that apply)
Paper
o Letter Size
o Legal Size
o Bound Volumes
Q Cards
o Computer Printout
::J Maps, Drawings, Plans
o Other (Specify)
contin~ below
Total Quantity
9.
i -----------1
(Cubic Feet)
contin~ below
10. Annual Accumulation
I...........................................................
. (Cubic Feet)
Audio-visual
Microfilm
o 16mm Roll Film
Q 35mm Roll Film
Q Microfiche
Q Aperture Cards
CI Other (Specify)
Electronic Records
(Complete Item #1 7)
Q Tape
o Hard Disk
o Diskette (Floppy Disk)
a Optical Disk
CI CO ROM
Q Other (Specify)
Q Audio Tape
Q Videotape
Q Motion Picture
Q Photo Prints
Q Film Negative
Q Photo-color Slides
Q Other (Specify)
Contin~ below
contin~ below
Conti~ below
Total Quantity
Total Quantity
Total Quantity
/
/
(Number of Items)
contin~ below
Annual Accumulation
(Rolls) (Items)
contin~ below
Annual Accumulation
(Bytes) (No. of Items)
Contin~ below
Annual Accumulation
/
/
(Number of Items)
(Rolls) (Items)
(Bytes) (No. of Items)
11. OFFICIAL COPYl
Q Yes Q No
I
I 12. OTHER COPIES?
Q Yes 0 No
I
I 13. REFERENCE FREQUENCY
, 0 Daily Q Seldom
o Weekly Q Never
o Monthly
HELD BY
14. POOR CONDITION!
o Yes QNo
15. RESTRICTED or CONFIDENTlAU
... - ,. .'-'-...,.-." -' ...
QYes a No
Local Government Records ServiCe!
LGRS-5 (7/95)
New York State Archives and Records Administration
- CoIIIiaued 011 otIw ride .
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~.,.;;..''''~.~.~*,JMll!nl"~_.. 4.
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2. RECORD SERIES TinE
5Lhcrl
.... a. BUILDING
(From)
6. DATE SPAN
BULK DATES
(From)
8. CHARAcrERISTICS (Check all that apply)
Paper
Q Letter Size
Q Legal Size
Q Bound Volumes
Q Cards
, :I Computer Printout
1 Cl Maps, Drawings, Plans
, :I Other (Specify)
9.
continf below
Total Quantity
(Cubic Feet)
cont;n~ below
10. Annual Accumulation
[._._--ic;;;;;;F;;;J---1
Inventory Worksheet
for Local Government Records
(To)
(To)
Audio-visual
U Audio Tape
::J Videotape
U Motion Picture
..J Photo Prints
! :I Film Negative
I Q Photo-color Slides
I :J Other (Specify)
I::~=========
contin1 below
Total Quantity
(Number of Items)
ContinL~ below
Annual Accumulation
(Number of Items)
1 c. UNIT
b. FLOOR c. ROOM
e. DRAWER or BOX
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological
o Other (SpecifyL......_.............................................
Microfilm
U 16mm Roll Film
, ::J 35mm Roll Film
I Q Microfiche
Q Aperture Cards
,:I Otner (Specify)
i
! ............................................................
conrin'f below
Total Quantity
/
(Rolls)
(Items)
Electronic Records
(Complete Item #17)
U Tape
U Hard Disk
U Diskette (Floppy Disk)
U Optical Disk
Q CD ROM
U Other (Specify)
continu~ below
T otaJ Quantity
/
(Bytes)
(No. of Items)
NOTE: See accompanying instructions before filling out this form.
la. GOVERNMENT NAME _ 1 b. DEPARTMENT
)-A--~
~:( \:U\lS
'4-~o-OO \C-r1-00
3. SARA SCHEDULE AND ITEM NUMBER 14. RETENTION PERIOD
OTHE.-sciiEDui{iN'm';;;d.;;;;;;;N;;;;;;;;;;j--.......m._.._......_._........-..---....-.....-.......--.....-1 De -:-c> -+ r tJ 'I
.N6fsCHEO.U'L'EO................................................................................................................................................... , () D 0
Contin~ below
Annual Accumulation
/
(Rolls) (Items)
Contin~ below
Annual Accumulation
/
(Bytes) (No. of Items)
11. OFFICIAL COPY?
U Yes U No
14. POOR CONDITIONl
QYes UNo
12. OTHER COPIES1
::i Yes U No
HELD BY
13. REFERENCE FREQUENCY
CI Daily U Seldom
CI ":Veek1y U Never
CI Monthly
Local Government Records Service
LGRS-5 (7/95)
1 S. RESTRICTED or CONFIDENTIAU
uYes UNo
New York State Archives and Records Administration
. Continued on other .. -
-
inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1 a. GOVERNMENT NAME 1 b. DEPARTMENT
1 c. UNIT
~-"b\- 00
3. SARA SCHEDULE AND ITEM NUMBER Q 14. RETENTION PERIOD
'OTHER'SEH'EOULE""lNa;:;je'~n(jJiem"Njj;:nb-e;r"""~"""\"~~'m......_......_...............
.NOT.SCHEDULfO..-...........-....--............-...-..................-..................-....-....-...-...-......-----...-........
~o~
. a. BUILDING
(From)
BULK DATES
(From)
b. FLOOR 'c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronologic.oi
o Other (Specify}_._____._.____..
(To)
8. CHARAClCRIST/CS (Check all that apply)
Paper
::J Letter Size
::J Legal Size
::J Bound Volumes
::J Cards
::J Computer Printout
::J Maps, Drawings, Plans
::J Other (Specify)
.......--........-....................-.-.-......................
.-..---...-----------
-.---.------.--....-..
Cantin~ below
9. Total Quantity
I---(C;bk~---I
Contin~ below
10. Annual Accumulation
I--(c~ II
Audio-visual
Electronic Records
(Complete Item #1 i)
Q Tape
::J Hard Disk
Q Diskette (Floppy Cisk)
Q Optical Disk
Q CD ROM
o Other (Specify)
Microfilm
I Q 16mm Roll Film
. ::. 35mm Roll Film
! Q Microfiche
.:. ApertUre Cards
i ::J Other (Specify)
i _._...___.........._._.__..._.......
;
a Audio Tape
a Videotape
a Motion Picture
a Photo Prints
a Film Negative
a Photo-color Slides
a Other (Specify)
..........-..-.........................-.........-..........---
..-..-...--........----.------.-.
...-...-..-.......-................---.......-..........
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Total Quantity
Total Quantity
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/
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(~olls) (Items)
(Bytes) (No. of Items)
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(Number of Items)
/
/
(Rolls) (Items)
(Bytes) (No. of hems)
11. OFFICIAL COPY?
a Yes Q No
HELD BY
13. REFERENCE FREQUENCY
a Dai Iy U Seldom
a \yeek1y a Never
a Monthly
12. OTHER COPIESl
a Yes 0 No
-..........--..-............----..--..--.....-.-..-........-.
14. POOR CONOmONl
~ ...,
a Yes a No
15. RESTRICTED orCONflDENTlAU
a Yes a No
New York State Archives and Records Administration
. - ContinI.Ied .. .....
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Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1 a. GOVERNMENT NAME 1 b. DEPART NT
- "l
3. 5
1 c. UNIT
5)
RETENTION PERIOD
NOT SCHEDULED
OTHER SCHEDULE (Name and Item Number)
6-00l,
a. BUILDING
6. DATE SPAN
(From)
BULK DATES
(From)
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
o Alphabetical
a Alphanumeric
o Numerical 0 Chronological
o Other (SpecifyJ...........................................................
(To)
8. CHARACTERISTICS (Check all that apply)
Paper
I U Letter Size
U Legal Size
:I Bound Volumes
::. Cards
::. Computer Printout
::. Maps, Drawings, Plans
::. Other (Specify)
9.
continu~ below
Total Quantity
.mmm.....mmm_mmm I
(Cubic Feet)
Contin~ below
10. Annual Accumulation
ImmmmiC;;;';;F;;;;}m-1
Audio-visual
Electronic Records
(Complete Item #1 7)
Microfilm
a 16mm Roll Film
::J 35mm Roll Film
::J Microfiche
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::J Other (Specify)
I~
Iu
::.
a
Q Audio Tape
I ~ Videotape
..... Motion Picture
::J O~oto Prj nts
a Film Negative
U Photo-color Slides
U Other (Specify)
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contin~ below
Continu-;, below
Total Quantity
Total Quantity
Total Quantity
/
/
(Number of Items)
Contin~ below
Annual Accumulation
(Roils) (Items)
contin~ below
Annual Accumulation
(Bytes) (No. of Items)
contin~ below
Annual Accumulation
/
/
(Number of Items)
(Rolls) (Items)
(Bytes) (No. of Items)
11. OFFICIAL COPY?
a Yes a No
HELD BY
14. POOR CONDITIONJ
a Yes Q No
i 12. OTHER COPIES?
I
::. Yes a No
113. REFERENCE FREQUENCY
· a Daily Q Seldom
Q V:Veek1y Q Never
Q Monthly
....__ ............ .........nn........._.._unu..................................._...
15. IfSTRICTED or CONFIDENTIALl
aVes a No
New York State Archives and Records Administration
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Local Government Records Service!
LGas-s fl/9S)
_I~ ml'l!', '.' ",~)[.ij~~.,
Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1 a. GOVERNMENT NAM'-r-:: 1 b. DEPARTMENT
\~
2. RECORD SERIES TinE
5 ~ ~ b\\'..S
\ c - \ CD
3. .~~:.~~L:.:~~..=...........\~.:1~......n..m....m.......................
OTHER SCHEDULE 'Name and Item Number)
~o
1c. UNIT
4. RETENTION PERIOD
........................................__..............................................nn..........nn..n.............................................................................
NOT SCHEDULED
a. BUILDING
(To)
6. DATE SPAN 'From)
BULK DATES (From)
(To)
8. CHARACTERISTICS (Check all that apply)
Paper
Audio-visual
o Letter Size
o Legal Size
o Bound Volumes
CI Cards
:J Computer Printout
I Q Maps, Drawings, Plans
:l Other (Specify)
Q Audio Tape
Q Videotape
Q Motion Picture
Q Photo Prints
Q Film Negative
Q Photo-color Slides
U Other (Specify)
Continu~ below
Continu~ below
9.
Total Quantitv
Total Quantity
(Cubic Feet)
(Number of Items)
Contin~ below
Annual Accumulation
conlinu~ below
10. Annual Accumulation
1...........................................-.......-...
. (Cubic Feet)
1-----------
I (Number of Items)
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d. CABINET or SHELF e. DRAWER or BOX
b. FLOOR i c. ROOM
I
7. ARRANGEMENT
Q Alphabetical
a Alphanumeric
o Numerical Q Chronological
o Other (SpecifyL.........................................................
Q
I~
'::I
::.
Microfilm
16mm Roll Film
3Smm Roll Film
Microfiche
Aperture Cards
Other (Specify)
Electronic Records
(Complete Item #17)
Q Tape
Q Hard Disk
Q Diskette (Floppy Disk)
CI Optical Disk
Q CD ROM
Q Other (Specify)
Continu~ below
Total Quantity
/
. (Bytes)
(No. of Items)
contin1 below
Total Quantity
/
(Rolls)
(Items)
contin1 below
Annual Accumulation
/
(Bytes) (No. of Items)
11. OFFICIAL COPY?
Q Yes CI No
12. OTHER COPIESl
CI Yes CJ No
HELD BY
contin~ below
Annual Accumulation
/
(Rolls) (Items)
...........__..U...........h....n...un~.._....n_...n_....._.......................---.
14. POOR CONDmONl
Q Yes Q No
15. RESTRICTED or CONFIDENTlAU
o Yes 0 No
I 13. REFERENCE FREQUENCY
a Daily CI Seldom
Q 'vYeekly Q Never
o Monthly
New York State Archives and Records Administration
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Local Government Records ServiCe!
. . lGRS-S (7/95)
'".""t"",;, ..:;"',;:~t:!::~'.~l'.':~'.~
I nventory Worksheet
for Local Government Records
1 c. UNIT
~
'OiHER"s6.j'Ei5uii"(Name-'a'n;{jiem.'N~mt;e;T""".'"''''''...'''.........................m.................................................
NOT SCHEDULED
.......................................................................................................................................................................................
a. BUILDING
(From)
6. DATE SPAN
BULK DATES
(From)
8. CHARACTERISTICS (Check all that apply)
Paper
CI letter Size
CI legal Size
I CI Bound Volumes
. ::J Cards
I CI Computer Printout
I Q Maps, Drawings, Plans
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9.
continu~ below
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(Cubic FeeV
continu~ below
10. Annual Accumulation
1...._...iC;;b;~;:;;;;;)-.......1
(To)
(To)
Audio-visual
CI Audio Tape
CI Videotape
CI Motion Picture
,.j Photo Prints
::. Film Negative
CI Photo-color Slides
.::1 Other (Specify)
I
____............--....-...1
continuf below
Total Quantity
(Number of Items)
continf below
Annual Accumulation
(Number of Items)
d. CABINET or SHelF e. DRAWER or BOX
7. ARRANGEMENT
U Alphabetical
U Alphanumeric
o Numerical U Chronological
o Other (Specify)......_._..._......................................
Microfilm
I CI 16mm Roll Film
, ::i 35mm Roll Film
::. Microfiche
::J .-\pertu re Cards
::. Other (Specify)
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Total Quantity
/
(Rolls)
(Items)
Electronic Records
(Complete Item #1 7)
Q Tape
::i Hard Disk
Q Diskette (Floppy Disk)
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::a CD ROM
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/
(Byres;
(No. of Items)
contin~ below
Annual Accumulation
/
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continf below
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/
(Bytes) (No. of Items)
11. OFFICIAL COPY?
Cl Yes CI No
14. POOR CONDmoNt
a Yes Q No
i 12. OTHER COPIES?
I
:I Yes a No
HELD BY
........n.n................................................................................
... .....n.................. . .......... ........ n..... ..........nn.
15. RESTRICTED or CONFIDENTlAU
aYes a No
113. REFERENCE FREQUENCY
; ::J Dai Iy CI Seldom
CI Weekly a Never
a Monthly
New York State Archives and Records Administration
c........... .*~ ".c!-.,,,...;~....~.,-~,:~,';,....-'
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local Govemment Records Service!
LG~ f7/95)
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Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1 b. DEPARTMENT
1c. UNIT
;ldl)fJ - /) I SeA ~~/ T~
e -I-c..,
ENTION PERIOD
D esh-o 'j
;)(Jo7
.OTHER..s.Ej:iEDf.TCf(Name.a.;j;Tiiem..Numt;;;;r.................................................................................................
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NOT SCHEDULED
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6. (From)
BULK DATES (From)
(To)
I b. FLOOR I c. ROOM
I ,
7. ARRANGEMENT
a Alphabetical
a Alphanumeric
d. CABINET or SHELF e. DRAWER or BOX
(To)
o Numerical a Chronological
o Other (SpecifyL......................................................
8. CHARACTERISTICS (Check all that apply)
Paper
U Letter Size
o Legal Size
I a Bound Volumes
I a Cards
::J Computer Printout
::J Maps, Drawings, Plans
a Other (Specify)
conrinu~ below
9.
T otat Quantity
(Cubic Feet)
conrin~ below
10. Annual Accumulation
I .__.._--(C;b;~F.;;;)..._...--1
Audio-visual
Microfilm
Q 16mm Roll Film
Q 35mm Roll Film
Q Microfiche
Q Aperture Cards
Q Other (Specify)
Electronic Records
(Complete Item #1 7)
U Tape
U Hard Disk
U Diskette (Floppy Disk)
'::J Ootical Disk
Q CD ROM
U Other (Specify)
Q Audio Tape
Q Videotape
a Motion Picture
Q Photo Prints
, Q Film Negative
Q Photo-color Slides
o Other (Specify)
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concin~ below
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Total Quantity
Total Quantity
/
/
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(No. 0; Items)
(Number of Items)
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Annual Accumulation
(Rolls)
(Items)
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Annual Accumulation
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Annual Accumulation
/
/
(Bytes) (No. 0; Items)
(Number of Items)
(Rolls) (Items)
11. OFFICIAL COPY?
a Yes '::I No
12. OTHER COPIES?
o Yes U No
HELD BY
13. REFERENCE FREQUENCY
U Daily Q Seldom
U 'v;Veekly Q Never
a Monthly
...................... .................... ................................ ......un..... '_0.
14. POOR CONDITION'
a Yes U No
15. RESTRICTED or CONFIDENTIAl?
Q Yes U No
Local Government Records Service!
LGRS-S (7/9S)
New York State Archives and Records Administration
- COIItinued 011 other lide -
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Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
la.GOVERNMENT NAME ---r-;; lb. DEPARTMENT
\~
2.~ SERIES TinE
~~\~
\ c
~-~,,- ~-~\-O\
3. SARA SCHEDULE AND ITEM NUMBER
lc. UNIT
\~ DY.... ~ O~ ~
/4. RETENTION PERIOD
.OTHER..S.6i"EoUL'f""iNanle.a.ii;nie;r;."Numb(irr....................................m......m....................................mm.m..
NOT SCHEDULED
~UJ7
. a. BUILDING
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
6. DATE SPAN
(From)
(To)
7. ARRANGEMENT
Q Alphabetical
Q Alphanumeric
Q Numerical 0 Chronological
Q Other (SpecifyL........_....._.............._........._.....
BULk DATES
(From)
(To)
8. CHARACTERISTICS (Check all that apply)
Paper
I Q Letter Size
! Q Legal Size
/. CI Bound Volumes
U Cards
I u Computer Printout
Q Maps, Drawings, Plans
I U Other (Specify)
Audio-visual
Microfilm
I Q 16mm Roll Film
, ::i 35mm Roll Film
Q Microfiche
Q Aperture Cards
Q Other (Specify)
Electronic Records
(Complete Item #1 7)
I CI Tape
U Hard Disk
I U Diskette (Floppy Disk)
Q Optical Disk
Q CDROM
. Q Other (Specify)
Q Audio Tape
Q Videotape
Q Motion Picture
Q Photo Prints
Q Film Negative
Q Photo-color Slides
Q Other (Specify)
Cootin~ be/ow
contin1 be/ow
contin~ be/ow
contin~ be/ow
Total Qua'l.tity
Total Quantity
Total Quantity
Total Quantity
9.
j---tc;;WcF;;;;)---1
Cootin~ be/ow
10.. Annual Accumulation
I ..........-.......--...-........--...........-
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/
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contin~ ~Iow
Annual Accumulation
(Rolls) (Items)
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(Bytes) (No.of/tems)
cantin, below
Annual Accumulation
II-~;be~--I
/
(RoJ/s) (Items)
/
(Bytes) (No. of Items)
11. OFFICIAL COPYl
Q Yes Q No
12. OTHER COPIES?
o Yes 0 No
HELD BY
13. REFERENCE FREQUENCY
Q Daily 0 Seldom
o \yeeldy 0 Never
o Monthly
14. POOR CONDITION?
Q Yes Q No
. .. .. ................... . .......... .. ..
15. RESTRICTED or CONFIDENTIAL?
QYes ONa
. ~..,.,~..it;.;;.;~::~.... _'..., ".. ......
-
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Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1a.GOVERNMENT ~ ., 1b.DEPARTMENT
;;. To~RIES1rf -F-:f J G ~ -
_fJD_-:1_f!)~ S~tJol r..)( ~J-/./~.fil
1 c. UNIT
3. SARA SCHEDULE AND ITEM NUMBER 14. RETENTION PERIOD
'OTHER"s'(iiEDui:E'TNa";;;'a'n,Fiiem"N~mbe;T""""''''''.................................................................................... IDe siN Y
.NoT.scHEDij'LEo..............................................................................................................................................m.. eQ 0 0 7
a. BUILDING
(From)
6. DATE SPAN
BULK DATES
(From)
8. CHARACTERISTICS (Check all that apply)
Paper
I CI Letter Size
I CI Legal Size
CI Bound Volumes
! :i Cards
::a Computer Printout
W Maps, Drawings, Plans
::J Other (Specify;
.......__..uun........_.................................u........
........ ............... .nn.................................n.......
... .__....................___........ ._...........n.._.........
contin~beiOW
9. Total Quantity
~-iC;;;;;'F~"----1
conrin~ below
10. Annual Accumulation
1-..._....(C;;bi~F.;;;....._..--1
(To)
(To)
Audio-visual
CI Audio Tape
o Videotape
CI Motion PictUre
CI Photo Prints
II CI Film Negative
CI Photo-color Slides
I U Other (Specify)
I ...........................................................
._..........................._..nn..........................................
....n_.... .................u.....u..............u.........
Continu-f below
Total Quantity
..n...............................................-........
(Number of Items)
Contin~ below
Annual Accumulation
.-.............................................................
(Number of Items)
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
7. ARRANGEMENT
a Alphabetical
a Alphanumeric
a Numerical 0 Chronological
o Other (SpeclfyL........_..............................................
Microfilm
U 16mm Roll Film
CI 35mm Roll Film
CI Microfiche
Q Aperture Cards
Q Other (Specifyj
Electronic Records
(Complete Item #17)
CJ Tape
CJ Hard Disk
CJ Diskette (Floppy Disk)
i a Optical Disk
; Q CD ROM
! Q Other (Specify)
--.....-......---.............--.......-. ..-- .-..........
.........__......._.......................... n...........
...-...............................................-......
..........n...._........n.............nun......n.n....
contin~ below
conrinu,,- below
Total Quantity
Total Quantity
1...0000...................... /
, (Bytes) (No. 0; Items)
contin1 below
Annual Accumulation
/
(Rolls) (Items)
Contin~ below
Annual Accumulation
/
/
(Bytes) (No. of Items)
(Rolls) (Items)
11. OFFICIAL COPY?
U Yes CI No
'4. POOR CONDITION1
o Yes U No
12. OTHER COPIES?
Q Yes CI No
HELD BY
u.un......................n................_n..........u............n ....................
: 13. REFERENCE FREQUENCY
i CI Daily 0 Seldom
I
CI Weekly Q Never
a Monthly
15. RESTRICTED or CONfIDENTlAL1
aVes Q No
New York State Archives and Records Administration
1
Local Government Records ServiCe!
_ c.rtinuefl till fIIIter __-.. . .. . . o'r",. LGRS-5(7~
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Inventory Worksheet
for Local Government Records
1 c. UNIT
()~:l.1 - 1Jd. /.28' /tJl ~f 3~" ~,~ / '
, , ~
4. RETENTION PERIOD
b. FLOOR i c. ROOM
Dt!.s-frcy
dl007
d. CABINET or SHELF e. DRAWER or BOX
.OTHER..Sc.ii"EouiE..(Name.iiii,riiem.Nun;be;j...................................................................................................
NOT SCHEDULED
..n.............___......................................................................................................................................................................
a. BUILDING
(From)
6. DATE SPAN
BULK DATES
(From)
(To)
7. ARRANGEMENT
Q Alphabetical
U Alphanumeric
Q Numerical Q Chronological
U Other (SpecifyL.....................__............................
(To)
8. CHARACTERISTICS (Check all that apply)
Paper
o Letter Size
o Legal Size
o Bound Volumes
o Cards
o Computer Printout
CI Maps, Drawings. Plans
. U Other (Specify)
continu~ below
9.
Total Quantity
(Cubic Feet)
continf below
10. Annual Accumulation
1......................................................_...
. (Cubic Feet)
Audio-visual
Microfilm
o 16mm Roll Film
Q 35mm Roll Film
Q Microfiche
::. Aoerture Cards
::. Other (Specify)
Electronic Records
(Complete Item #17)
Q Tape
o Hard Disk
Q Diskette (Floppy Disk)
a Optical Disk
U CD ROM
U Other (Specify)
a Audio Tape
a Videotape
a Motion Picture
a Photo Prints
U Film Negative
a Photo-color Slides
U Other (Specify)
contin~ below
continf below
cont;nu~ below
Total Quantity
Total Quantity
Total Quantity
I i
/
/
(Roils)
(Items)
(Bytes) (No. of Items)
Contin~ below
Annual Accumulation
1............................- /
I (Bytes) (No. of Items)
(Number of Items)
continf below
Annual Accumulation
continf below
AnnuaJ Accumulation
/
(Number of Items)
(Rolls) (Items)
11. OFFICIAL COPYl
Q Yes .:;j No
HELD BY
12. OTHER COPIESl
Q Yes a No
/13. REFERENCE FREQUENCY
Q Daily 0 Seldom
o Weekly 0 Never
o Monthly
14. POOR CONDITIONt
o Yes 0 No
15. RESTRICTED or CONflDENTIAU
o Yes aNa
New York State Archives and Records Administration
Local Government Records ServiCe!
LGRS-S (7/95)
~'JilI' .'j' r- 'I 'j..1I II.
~..l'^'\.h .~....,~.';
- (\llId II1ed ... ...... ~ -
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f::-...i1~:i.('"
NOTE: See accompanying instructions before filling out this form.
1a.GOVERNMENT ~c , . ~ 1b.DEPARTMENT
I f\'X Clli L L
2. RECOR~ERIES TJnE ! - c::::::
CO I rl.lJD ").... ~c..hoo \
I
3. SARA SCHEDULE AND ITEM NUMBER
Inventory Worksheet
for Local Government Records
1c. UNIT
~()
4. l)e;fnJ Y
~oo7
'OTHER"sc'H'EDui:E'"iName'a;;cFiiem'N~mbe;T""""""'''''''..............................................................................
.NOT.scHEDuiio...................................................................................................................................................
. . a. BUILDING
6. DATE SPAN (From)
BULK DATES (From)
(To)
b. FLOOR c. ROOM
i
I
7. ARRANGEMENT
Q Alphabetical
o Alphanumeric
d. CABINET or SHELF e. DRAWER or BOX
(To)
Q Numerical Q Chronoiogical
o Other (Specify}...........................................................
8. CHARACTERISTICS (Check all that apply)
Paper
Cl Letter Size
Cl Legal Size
Cl Bound Volumes
Cl Cards
CI Computer Printout
::i Maps, Drawings, Plans
. 0 Other (Specify)
contin1 below
9.
Total Quantity
_.m.....m.~.___..1
(Cubic Feet)
Contin1 below
10. Annual Accumulation
1--(c~:F.;V.-1
Audio-visual
Microfilm
16mm Roll Film
35mm Roll Film
Microfiche
Aperture Cards
Other (Specify)
Electronic Records
(Complete Item #17)
Cl
Cl
o
Cl
I~
I ..........................................................
Cl Audio Tape
Cl Videotape
o Motion Picture
Cl Photo Prints
I 0 Film Negative
I U Photo-color Slides
, U Other (Specify)
Cl
o
1:-
Q
,_
,;.J
Tape
Hard Disk
Diskette (Floppy Disk)
Optical Disk
CD ROM
Other (Specify)
contin1 below
contin~ below
Contin1 below
Total Quantity
Total Quantity
Total Quantity
/
/
(Number of Items)
contin~ below
Annual Accumulation
(Rolls) (Items)
Contin1 below
Annual Accumulation
(Bytes) (No. of Items)
cantin.. below
Annual Accumulation
I /
I .........{8~;j......- (No. of Items)
.:"--:'.
/
(Number of Items)
(Rolls) (Items)
11. OFFICIAL COPY?
Q Yes Q No
HELD BY
I 13. REFERENCE FREQUENCY
Cl Daily Q Seldom
Cl Weekly Q Never
Q Monthly
12. OTHER COPIES?
Q Yes Q No
14. POOR CONDITION?
Cl Yes 0 No
1 S. RESTRICTED or CONFIDENTIAU
Cl Yes Cl No
New York State Archives and Records Administration
- Continued on other _-
Local Government Records ServiCe!
lGRS-5 (7/95>,
,J ~.IJ~J* ",,,..,j.,., t!lIt~..:,,,,,~~$,,,._~,~~.
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Inventory Worksheet
for Local Government Records
x
NOTE: See accompanying instructions before filling out this form.
1a.~ERNMENT N~ ' 1 b. DEPARTMENT
~ ~ I t.."-
2. RECORD SER~mE '-I:
~IJ()J ~} V
/
1 c. UNIT
~~,~, -F~h. ~~~,t:JJ
3. SARA SCHEDULE AND ITEM NUMBER 14. RETENTION PERIOD
.OTHER..SC"H"EOULE..fName..a.iiiriiem.Numbe;r.................................................................................................' D e .sf r () I
;J. Ot) 7
NOT SCHEDULED
............uu........................................un..............n............n...........n...............................................n.........._.............__....
a. BUILDING
6. DATE SPAN (From)
BULK DATES (From)
(To)
(To)
b. FLOOR i c. ROOM
i
I
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
d. CABINET or SHELF e. DRAWER or BOX
o Numerical 0 Chronological
o Other (Specify}...........................................................
8. CHARACTERISTICS (Check all that apply)
Paper
Q Letter Size
Q Legal Size
Q Bound Volumes
Q Cards
Cl Computer Printout
::J Maps, Drawings, Plans
:i Other ISpeciF/)
continu. below
9.
Total Quantity
mmmmmm___mmm...m I
(Cubic FeeV
contin~ below
10. Annual Accumulation
I .._-_...-;c-;;b;~F.;;;I--.._._.-1
Audio-visual
Q Audio Tape
Q Videotape
Q Motion Picture
.:;:, Photo Prints
: Q Film Negative
: Q Photo-color Slides
: Q Other (Specify)
contin. below
Total Quantity
(Number of Items)
Contin~ below
Annual Accumulation
(Number of Items)
Microfilm
Q 16mm Roll Film
::a 35mm Roll Film
I a Microfiche
:J -\oerture Cards
Q Other (Specify)
Electronic Records
(Complete Item #17)
I Q Tape
I Q Hard Disk
I
I Q Diskette (Floppy Disk)
:J Optical Disk
a CD ROM
, a Other (Specify)
contin. below
Total Quantity
contim~ below
Total Quantity
/
/
(Rolls) (Items)
contin~ below
Annual Accumulation
(Bytes) (No. of Items)
contin~ below
Annual Accumulation
/
/
(Rolls) (Items)
(Bytes) (No. of Items)
11. OFFICIAL COPYl
Q Yes Q No
12. OTHER COPIESl
Q Yes Q No
HELD BY
I
I 13.
ICl
Q
Q
REFERENCE FREQUENCY
Daily 0 Seldom
~eekly Q Never
Monthly
14. POORCONDlnONl
IJ Yes Q No
15. RESTRICTED or CONflDENTlAU
Q Yes Q No
New York State Archives and Records Administration
I tJ,.~~,~~
. CtIaf/nued .. .... Me -
.~; -t. iio}.., ""l< '.. r-' - .... ..._,...,.;...~.""~Fjt~..i.::q,#". ~tfii"u~i'li "'i 'j
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local Govemment Records Service!
LCiRS-5 ,1,]/95)
'i "f 1m1 r IJ~lt1.;lt.,
-, ......
Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
la. GOVERNMENT NAME 1 b. DEPARTMENT
lc.UNIT
2. RECORD SERIES TITLE
-<.001 . 02-
~OO').... t \i:t, LWO-~~ \ ~~Oy..J
3. .~~:~;~\;~:.~~:S.~.\.......~~..........~~.~.~.~.C.~.............. 4.
OTHER SCHEDULE (Name and Item Number)
.NOT.SCHEO.U"LEO...................................................................................................................................................
a 00 ~
a. BUILDING
(From)
6. DATE SPAN
BULK DATES
(From)
8. CHARACTERISTICS (Check all that apply)
Paper
1:1 Letter Size
1:1 Legal Size
1:1 Bound Volumes
1:1 Cards
1:1 Computer Printout
Q Maps, Drawings, Plans
1:1 Other (Specify)
Continu-f below
Total Quantity
9.
1----------
(Cubic Feet)
Cantin, below
10. Annual Accumulation
I ------------iC;;;,kF~-1
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
Q Alphabetical
Q Alphanumeric
Q Numerical Q Chronological
Q Other (SpecifyL.........................................................
(To)
Audio-visual
Microfilm
a 16mm Roll Film
a 35mm Roll Film .
a Microfiche
a Aperture Cards
a Other (Specify)
Electronic Records
(Complete Item #17)
1:1 Tape
1:1 Hard Disk
1:1 Diskette (Floppy Disk)
a Optical Disk
1:1 CD ROM
1:1 Other (Specify)
1:1 Audio Tape
1:1 Videotape
1:1 Motion Picture
1:1 Photo Prints
1:1 Film Negative .
1:1 Photo-color Slides
1:1 Other (Specify)
........;,.................................................................
Contin~ below
Total Quantity
Cantin, below
Total Quantity
Cantin, below
Total Quantity
/
/
(Bytes) (No. of Items)
Contin~ below
Annual Accumulation
(Number of Items)
contin~ below
Annual Accumulation
(Rolls) (Items)
Cantin, below
Annual Accumulation
/
/
(Bytes) (No. of Items)
(Number of Items)
(Rolls) (Items)
11. OFFICIAL COPYl
Q Yes Q No
12. OTHER COPIESl
o Yes Q No
HELD BY
13. REFERENCE FREQUENCY
o Daily 0 Seldom
o Weekly 0 Never
o Monthly
14. POOR CONDlTIONl
1:1 Yes 0 No
...............n...................................................................................................
15. RESTRICTED or CONFIDENTIAL1
o Yes 0 No
Local Government Records Service!
LGRS.5 (7/95)
New York State Archives and Records Administration
- Continued on other side.
Inventory Worksheet
for local Government Records
NOTE: See accompanying instructions before filling out this form.
1 a. GOVERNMENT NAME 1b. ~NT
\ ~\J-
2. RECORD SERIES TITLE
1c;UNIT
)
'OTHER"S(;"H'Ejji]i:E""jN;;mi;'and"ii~m'Numt;e;r"''''''''''''''''''''''.........................................................................
.....................................u.....................................................................................-..................-.....................--........................................................
NOT SCHEDULED
aOD'-'
""",' a. BUILDING
(From)
6.
BULK DATES
(From)
8. CHARACTERISTICS (Check all that apply)
Paper
o Letter Size
o Legal Size
CI Bound Volumes
o Cards
CI Computer Printout
CI Maps, Drawings, Plans
CI Other (Specify)
cont;n~ below
Total Quantity
9.
1--.---..------
(Cubic Feet}
Contin'f below
10. Annual Accumulation
(Cubic Feet}
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological
o Other (SpecifyL.........................................................
(To)
Audio-visual
Microfilm
a 16mm Roll Film
a 35mm Roll Film .
a Microfiche
a Aperture Cards
a Other (Specify)
Electronic Records
(Complete Item #1 7)
CI Tape
CI Hard Disk
CI Diskette (Floppy Disk)
CI Optical Disk
CI CD ROM
CI Other (Specify)
CI Audio Tape
CI Videotape
CI Motion Picture
Q Photo Prints
CI Film Negative .
CI photo-color Slides
CI Other (Specify)
Contin~ below
Contin~ below
Total Quantity
Contin~ below
Total Quantity
Total Quantity
/
/
(Number of Items)
Continttf below
Annual Accumulation
(Rolls) (Items)
Contin'!f below
Annual Accumulation
(8 ytes) (No. of Items)
Contin'!f below
Annual Accumulation
/
/
(Number of Items)
(Rolls)
(No. of Items)
(Items)
(8 ytes)
11. OFFICIAL COPY?
CI Yes 0 No
HELD BY
12. OTHER COPIES?
CI Yes CI No
13. REFERENCE FREQUENCY
o Daily 0 Seldom
CI \yeek1y 0 Never
o Monthly
14. POOR CONDITION?
CI Yes 0 No
15. RESTRICTED or CONFIDENTIAL?
CI Yes CI No
New York State Archives and Records Administration
- Continued on other side -
local Government Records Service!
lGRS-5 (7/95)
Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1 a. GOVERNMENT NAME 1 b. DEP~TMENT
~ ~~
2. RECORD SERIES TITLE
1c;UNIT
~CO~ tj . C;;~
3. SARA SCHEDULE AND ITEM NUMBER
\o..~
l\\5
~
4. RETENTION PERIOD
'OTHER"SC:"H'EDULE"jN~;;;~'a~;:Fiie;;;'Niimt;e;r""'"''''''''''''..............................................................................
NOT SCHEDULED
a. BUILDING
(From)
6. DATE SPAN
BULK DATES
(From)
8. CHARACTERISTICS (Check all that apply)
Paper
Q Letter Size
Q Legal Size
Q Bound Volumes
Q Cards
Q Computer Printout
U Maps, Drawings, Plans
Q Other (Specify)
Contin~ below
Total Quantity
9.
I _0____0_______
(Cubic FeetJ
Contin~ below
10. Annual Accumulation
(Cubic FeetJ
a ()O~
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological .
o Other (SpecifyL.........................................................
(To)
Audio-visual
Electronic Records
(Complete Item #1 7)
Q Tape
Q Hard Disk
Q Diskette (Floppy Disk)
Q Optical Disk
Q CD ROM
Q Other (Specify)
Microfilm
o 16mm Roll Film
o 35mm Roll Film
o Microfiche
o Aperture Cards
Q Other (Specify)
Q Audio Tape
Q Videotape
Q Motion Picture
Q Photo Prints
Q Film Negative .
Q Photo-color Slides
Q Other (Specify)
Contin~ below
Total Quantity
Contin~ below
Total Quantity
Contin~ below
Total Quantity
/
/
(Number of Items)
Contin~ below
Annual Accumulation
(Rolls) (Items)
Contin~ below
Annual Accumulation
(Bytes) (No. of Items)
Contin~ below
Annual Accumulation
/
/
(Number of Items)
(Rolls)
(Items)
(Bytes)
(No. of Items)
11. OFFICIAL COPY?
Q Yes Q No
HELD BY
12. OTHER COPIES?
a Yes 0 No
13. REFERENCE FREQUENCY
a Daily Q Seldom
a Weekly Q Never
Q Monthly
14. POOR CONDITION?
Q Yes Q No
15. RESTRICTED or CONFIDENTlAU
o Yes 0 No
New York State Archives and Records Administration
- Continued on other side -
local Government Records Service!
LGRS-5 (7/95)
Inventory Worksheet
for local Government Records
NOTE: See accompanying instructions before filling out this form.
1 a. GOVERNMENT NAME 1 b. DEPARTMENT
- \ '~
2. RECORD SERIES TITLE
1 c.UNIT
~~v
3. SARA SCHEDULE AND ITEM NUMBER
~DO~
4. RETENTION PERIOD
'OTHER"s'cj.j"EDj]LE"(Na;;;~";i~crit~m'Numt;ii;r""''''''''.....................................................................................
................................................................nu................................nu....__n..............................uu........._nn..........................................
NOT SCHEDULED
;;lOO~
.'."""". a. BUILDING
6.
(From)
BULK DATES
(From)
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological
o Other (SpecifyL.........................................................
(To)
8. CHARACTERISTICS (Check all that apply)
Paper
a Letter Size
a Legal Size
a Bound Volumes
a Cards
Q Computer Printout
U Maps, Drawings, Plans
a Other (Specify)
Contin~ be/ow
Total Quantity
9.
[ .--------..--.-.--1
(Cubic Feet)
Contin~ be/ow
10. Annual Accumulation
I -.--..-.-iC;;b;;:F;;;;;;...-......-1
Audio-visual
Electronic Records
(Complete Item #17)
Q Tape
Q Hard Disk
Q Diskette (Floppy Disk)
Q Optical Disk
a CD ROM
Q Other (Specify)
Microfilm
Q 16mm Roll Film
Q 35mm Roll Film
Q Microfiche
Q Aperture Cards
a Other (Specify)
a Audio Tape
CI Videotape
a Motion Picture
a Photo Prints
Q Film Negative .
a Photo-c%r Slides
a Other (Specify)
Contin~ be/ow
Contin~ be/ow
Contin'i be/ow
Total Quantity
Total Quantity
Total Quantity
/
/
(Number of Items)
(~olls) (Items)
Contin~ be/ow
Annual Accumulation
(Bytes) (No. of/tems)
Contin. be/ow
Annual Accumulation
Contin~ be/ow
Annual Accumulation
/
/
(Number of Items)
(Rolls) (Items)
(Bytes) (No. of Items)
11. OFFICIAL COPY1
Q Yes 0 No
HELD BY
12. OTHER COPIES1
Q Yes 0 No
13. REFERENCE FREQUENCY
Q Daily a Seldom
o Weekly a Never
Q Monthly
14. POOR CONDITION1
o Yes Q No
15. RESTRICTED or CONFIDENTlAU
QYes UNo
New York State Archives and Records Administration
- Continued on other side -
local Government Records Service!
lGRS-5 (7/95)
TOWN OF WAPPINGER
RECORDS DESTRUCTION AUTHORIZATION
In accordance with current New York State retention/disposition schedules, the
records listed below have been disposed of:
Department:
.~~.
Date:
~~~4
RECORDS SERIES
DATES
VOLUME
SCHEDULE
Page / item #
\<\C\~
R'LCD...h~ '\a( ~\l~
\
~ Cllr\.'x{ _ :s tr~ '<YI e-'1\~
\~C\'(
RECEIVED
MAY 1 7 20n~
TOWN CLERK
AUTHORIZATION
~~~* - 6lt/O~
Dept. Head/Des nee Date
DESTRUCTION
Date: ~klo~
Method: _~OAJ1a ~(L/
Signed:
NOTE: See accompanying instructions before filling out this form.
1a.GOVERNMENT NAME ____ 1b.DEPARTMENT
\~
~V V~OV\d~<.Q.....-
~
Inventory Worksheet
for Local Government Records
'f
1c. UNIT
2.
OU
.OTHEii..SCH.EDUi:'{INam;;.ancriiem.Nu;:,:;be;j""m........m..........m.........m...m....................................................
~OO~
NOT SCHEDULED
..........__..._........_............._.............._.....__............................._n............................................-.....................-...............-......................
9. Total Quantity
I----~~~---I
. continf beloIN' '. ,-. -
10. Annual Accumulation
I----(c;.~ II--(N~;t~-I
a. BUILDING
6. DATE SPAN
IFrom)
BULK DATES
IFrom)
B. CHARACTERISTICS (Check all that apply)
Paper
a Letter Size
a Legal Size
a Bound Volumes
Q Cards
a Computer Printout
Q Maps, Drawings, Plans
Q Other (Specify)
continu-f below
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
Q Alphabetical
Q Alphanumeric
o Numerical 0 Chronological
o Other (Specify}.__._......._...__....._.__
(To)
Audio-visual
Microfilm
a 16mm Roll Film
::i 35mm Roll Film
a Microfiche
Q Aperture Cards
a Other (Specify)
Electronic Records
(Complete Item #1 7)
la
la
la
~
a Audio Tape
a Videotape
a Motion Picture
a Photo Prints
a Film Negative
a Photo-color Slides
a Other (Specify)
Tape
Hard Disk
Diskette (Floppy Disk)
Optical Disk
1:1 CD ROM
a Other (Specify)
contin1 below
continf below
contin~ below
Total Quantity
Total Quantity
Total Quantity
/
/
(Number of Items)
IRa lis) (Items)
continf below
Annual Accumulation
(Bytes) INo. of Items)
contin1 below
Annual Accumulation
contin1 below
Annual Accumulation
/
/
(Rolls) (Items)
(ByteS) (No. of Items)
11. OFFICIAL COPY?
aVes Q No
12. OTHER COPIES?
Q Ves a No
HELD BY
13. REFERENCE FREQUENCY
a Daily 0 Seldom
a 'vYeek1y a Never
a Monthly
14. POOR cONDmONl
aVes Q No
15. RESTRICTED or CONFlDENTIALl
aVes 0 No
Local Government Reconk 5ervIc:e
New York State Archives and Records Administration
".<:,.~GtlI~LlIIIIt......... ~ ;, -.
,;Q c' '.'.' """'~,,,.,.!t--.......;h4;~..i;:l.!'O;"'....c
;;e;'i-...."?--',.~....::,l;~~'7:';.4fr.~:i ;.
~:i~",<iir~~~
Inventory Worksheet
for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1a.G;1R~MOTlfE S e-joo/ ~ / a.xlbf!!jjl~
2, RECORD lIES TITLE .. cj--
{)c . (]O - /VrJ 1/ 0'3, .:2 O(J
/' '
3. SARA SCHEDULE AND ITEM NUMBER
1c. UNIT
4, RETENTION PERIOD
.OTHER.s6i.EOl,-LE.TNarrje..i;neFii;in.'Nuinb;;r...----...........-----.---.....--.............--......................--....----....--.-.......
c1D/()
NOT SCHEDULED
......_._..........._......_.............._..u....__.___..__....__..................................._............_.........................................................--......................--................--..
a. BUILDING
(From)
6.
BULK DATES
(From)
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological
o Other (SpecifyL_._...__....___.__......__.__._.__..._______......
(To)
8. CHARACTERISTICS (Check all that apply)
Paper
U Letter Size
U Legal Size
U Bound Volumes
U Cards
U Computer Printout
U Maps, Drawings, Plans
U Other (Specify)
Contin~ below
Total-Quantity
"
1--------
(Cubic Feet)
Contin~ below
10. Annual Accumulation
1..-----......................----......-..--........---.
. ) (Cubic Feet)
Audio-visual
Microfilm
U 16mm Roll Film
U 35mm Roll Film
U Microfi che .
a Aperture Cards
U Other (Specify)
Electronic Records
(Complete Item #17)
U Tape
o Hard Disk
U Diskette (Floppy Disk)
U Optical Disk
U CORaM
U Other (Specify)
U Audio Tape
U Videotape
Q Motion Picture
Q Photo Prints
o Film Negative. .
U Photo-color Slides
U Other (Specify)
Contin~ below
Total Quantity
Contin~ below
Contin~ below
Total Quantity
Total Quantity
I
I
(Number of Items)
contin,; below
Annual Accumulation
(Rolls) (Items)
Cantin';' below
Annual Accumulation
(Bytes) (No. of Items)
Contin'T' below
Annual. Accumulation
I
I
(Number of Items)
(Rolls) (Items)
(Bytes) (No. of/tems)
11. OFFICIAL COPY1
a Yes Q No
12. OTHER COPIES?
U Yes U No
.HELD BY
13. REFERENCE FREQUENCY
Q Daily U Seldom
U \yeekly U Never
Q Month Iy
14. POOR CONDITION?
a Yes 0 No
15. RESTRICTED or CONFIDENTlAL1
U Yes U No
New York State Archives and Records Administration
local Government Records Service
Inventory Worksheet
for Local Government Records
3. SARA SCHEDULE AND ITEM NUMBER
4. RETENTION PERIOD
'OTHER"SC'H'Ej)uiE"iN~m;'a'~;Tiiem'Niimb'e;r'''''''''''''--''''''''......................--..............................--.................
(~{)/o
NOT SCHEDULED
............................................................................................................................................................................................................................
'a. BUILDING
(From)
6. DATE SPAN
BULK DATES
(From)
8. CHARACTERISTICS (Check all that apply)
Paper
U Letter Size
U Legal Size
U Bound Volumes
Q Cards
U Computer Printout
o Maps, Drawings, Plans
U Other (Specify)
Contin~ below
9. Totcrr Quantity
1------{C~bkF;;;;)--m I
Contin~ be/ow
10. Annual Accumulation
I .....,-................................................-...
. (Cubic Feet)
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological
o Other (SpecifyL..............................__._.__................
(To)
Audio-visual
Microfilm
U 16mm Roll Film
U 35mm Roll Film
U Microfiche
U Aperture Cards
U Other (Specify)
Electronic Records
(Complete Item #17)
U Tape
U Hard Disk
U Diskette (Floppy Disk)
U Optical Disk
U CD ROM
U Other (Specify)
U Audio Tape
U Videotape
U Motion Picture
U Photo Prints
U Film Negative .
U Photo-color Slides
U Other (Specify)
Contin~ be/ow
Total Quantity
cont;n~ below
Contin'f below
Total Quantity
Total Quantity
/
/
(Bytes) (No. of Items)
Contin, below
Annual Accumulation
(Number of Items)
(Rolls) (Items)
cont;n~ below
Annual Accumulation
contin, below
Annual Accumulation
I
/
/
(Bytes) (No. of Items)
(Number of Items)
(Rolls) (Items)
11. OFFICIAL COPY?
Q Yes Q No
12. OTHER COPIES?
U Yes U No
.HELD BY
13. REFERENCE FREQUENCY
o Daily U Seldom
o \yeekly U Never
o Monthly
14. POOR CONDITIONl
Q Yes Q No
~~......___..u_n.._.._u._n.._n_......_......__...._.n.._u._.............. .......................
15. RESTRICTED or CONFIDENTIAL?
U Yes U No
local Government Records Service
lGRS-5 (7/95)
New York State Archives and Records Administration
_ Continued on other .dd.. -
Inventory Worksheet
. for Local Government Records
NOTE: See accompanying instructions before filling out this form.
1a. CWVERNMENT NAME h J. - 1HE.PAiT~ENT
~ t Sc- .DO In)( ~I ~LS
2. RECOR SERIES 3:" _ - __ l' f: -7,; d. 0 () 'I-
3. SARA SCHEDULE AND ITEM NUMBER
1c.UNIT
4. RETENTION PERIOD
'6YHER"SCHEDui:E"iName-'a~d'iiem"Numbe;r"""""""...................................................................................
c2 () /0
.NOy.SCHEO"lj"LEO...................................................................................................................................................
a. BUILDING
(From)
6. DATE SPAN
BULK DATES
(From)
8. CHARACTERISTICS (Check all that apply)
Paper
o Letter Size
o Legal Size
o Bound Volumes
o Cards
o Computer Printout
o Maps, Drawings, Plans
o Other (Specify)
........-....-.......................-...............-........
..................-............-....-.........................-.....
....-........-..-...........................................---.......
Contin~ below
Total Quantity
9.
1----.---1
(Cubic Feet)
Contin~ below
10. Annual Accumulation
I -------;c;;;;F,;;",-1
b. FLOOR c. ROOM d. CABINET or SHELF e. DRAWER or BOX
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological
o Other (SpecifyL........................................................
(To)
Audio-visual
Microfilm
0 16mm Roll Film
a 35mm Roll Film
a Microfiche .
a Aperture Cards
a Other (Specify)
Electronic Records
(Complete Item #1 7)
a Tape
o Hard Disk
lJ Diskette (Floppy Disk)
o Optical Disk
lJ CD ROM
o Other (Specify)
o Audio Tape
o Videotape
o Motion Picture
o photo Prints
o Film Negative
o Photo-color Slides
o Other (Specify)
.............................................................e.
-...................................................-............
..........._..........................................................0'
.............................-..................-.......................
...............................................-...........................-
.....--......................................................................
.......................--................................--........--.......
........-....-.........................................--............
...............................................................................
..........................-.............................................-...
......--...................................................--..-......
.....-...--.--...-....-..................---.................-.
Contin~ below
Contin~ beiow
Total Quantity
Continu.f below
Total Quantity
Total Quantity
/
/
.............................................................-................
...................................--.
(Bytes) (No. of Items)
Contin~ below
Annual Accumulation
(Rolls) (Items)
Contin~ below
Annual Accumulation
(Number of Items)
Continr; below
Annual Accumulation
/
/
.....................................-.....................................
(Bytes) (No. of Items)
(Rolls) (Items)
(Number of Items)
11. OFFICIAL COPYl
o Yes lJ No
12. OTHER COPIESl
lJ Yes lJ No
HELD BY
13. REFERENCE FREQUENCY
a Daily lJ Seldom
a Weekly 0 Never
o MonthlY. .. . .......
14. POOR CONDITIONl
o Yes lJ No
............-........................................................................................-................
-........-..................................-....-................-.....................-.--............-.......
15. RESTRICTED or CONFIDENTIAU
lJ Yes lJ No
Local Government Records Service!
lGRS-5 (7/95)
New York State Archives and Records Administration
_ Continued on other side -
NOTE: See accompanying instructions before filling out this form.
1a. GOVERNMENT NAME 1 ~~Pl.it
- ~C)O~
Inventory Worksheet
, for Local Government Records
1 c. UNIT
\..u" if' tf'~ ......~
RETENTION PERIOD
'oTHER"scHEDuLE"(Na;;;~'a;;;Tji~m'Nii;;;b~;r""""""""...............................................................-.-........,.
~D\D
NOT SCHEDULED
.............___..._............_...-...u......_..__._.___._......._....._......-..-....---.....-......--....--..........--.....-...................-..-..................-............-..-.......-----...
h. FLOOR c. ROOM d. CABINET Dr SHELF e. DRAWER or BOX
a. BUILDING
(From)
6. DATE SPAN
BULK DATES
(From)
B. CHARACTERISTICS (Check all that apply)
Paper
U Letter Size
U Legal Size
U Bound Volumes
U Cards
Q Computer Printout
::I Maps, Drawings, plans
Q Other (Specify)
....-..---....--..---..----..-.
.-.....--..--.-..-..----..-...-..-.
-..-----..------.....
Contin~ below
~. T otat Quantity
I.--'-{~bio~-I
Contin~ below
10. Annual Accumulation
I .......................................--........-.
.) (Cubic Feet)
(To)
7. ARRANGEMENT
o Alphabetical
o Alphanumeric
o Numerical 0 Chronological
a Other (SpecifyL.._.._._.._.__............__...___...._
(To)
Audio-visual
Microfilm
Q 16mm Roll Film
Q 35mm Roll Film
Q Microfiche
Q Aperture Cards
Q Other (Specify)
Electronic Records
(Complete Item #1 7)
Q Tape
Q Hard Disk
Q Diskette (Floppy Disk)
Q Optical Disk
Q CD ROM
Q Other (Specify)
U Audio Tape
Q Videotape
U Motion Picture
Q Photo Prints
U Film Negative. .
U Photo-color Slides
Q Other (Specify)
._-_.---~._--_._--_..
--------------...-----.
--....-----.....----..--..-...
..-...--...-.--......---..-----....--.
-..----.....----.
-----.....-....--..----...
----------.
-------------.
---..------...--..-.....--..--..-----...
_...__0_-----------
---..-----------.
--------------------...
Contin~ below
Contin~ below
Total Quantity
contjn~ below
Total Quantity
Total Quantity
I
I
....---..........-......-....-........--...----..-........--
(Bytes) (No. of Items)
Contjn~ below
Annual' Accumulation
(Rolls) (Items)
cont;n~ below
Annual Accumulation
(Number of Items)
contjn~ below
Annual Accumulation
I
I
.............-..-..--.--....-..---....--....-..--......
(Bytes) (No. of Items)
(Rolls) (Items)
(Number of Items)
11. 0 FFI CIAL COPY1
U Yes Q No
12. OTHER COPIES?
Q Yes Q No
.HELD BY
13. REFERENCE FREQUENCY
Q Daily U Seldom
Q Weekly U Never
Q Month Iy
14. POOR CONDITION?
,U Yes Q No
--.--....--.........-....--....-....--..--..-...-.....-.........-........--..-....-..-...
Local Government Records Service
New York State Archives and Records Administration