Box 01
.'"
Records Inventory Data "\Norksheet
Set-.' IIISL"U~lIU1I:. III j-'ulJliCiJLiOI11i76, 1/1 V/1fJwr..I' wuJ Ph/I/IIII/Y, IJt~lll"l' c.:ulIll'leLiflfl LIII!, lun/I.
llJ. DEPARTMENT/UNIT
r la. COVERNMENT/ AGENCY
Tou.>o of L''"'-''- ~ ^"C",.
2 RECORDS SERlES 'ltrt.TI oJ
PUAC,UltSe OR..()e~S
.
~Q.'-{,QA.,-no r.
3. DATE SPAN
~OOli - ~OO q
4. RECORDS SERIES.DESCRIPTION (fJesc.:rilw c.:umem emcl cl1<Jl'Clclenslic.s 01 records)
~Q..C..c(,d5 ~~"\f'.9 io fl)rc.ha.~: inucic..cz.S, pu('c.hc...~a... orckrs
a.nd rni ~c.Cl..l\a..'f"'CLOVS ooeo mCLf\t:s ('Q...\c~:l\~~ -fa ~ purGhG..~S
/5. ARH..ANGEMENT
o Alphabetical 0 NumerIcal
o Dther (Specify):
6a RETENTION
o I\Jm scheduled 0 Permanem
ri ScheDuled retention:
~hfonological
o Alphanumeric
/------"-=~::-~~~-::-~
o Appraise for hiSLOrical value
//
/
;/ ;:-;\0 \ lo.
\ L/
\
~ /---~
--------------
\
\
\
\
)
/
/
/
;//
~ 4Q...o.-r ~ .
6b. SCHEDULEJ\.ND ITEM NUMBEP~ DR.REASONFORPROPOSEDRETENTION
. 1.f55~}
7. LOCATION
5. FORMAT
~apeJ
o AudiOVIsual
o Micrographic
o ElecLronic
o Cubic reel: o hems: Type or "ems:
10. ANNUAL ACCUMULATION (In cubIc leeL cu' number of lLems)\
o CubIC feeL: o llems:
11. EREQUENCY DP USE,
I o Daily o Weekly o Monthly ~ Seldom o Never
12 RESTRICTIONS ON USE
IRECORDS ARE
-
19 TOTAL QUNITITY (In cubic Jeet ornumulH of Ilems),
IJ.) 0 IN POOH CONDITJON
14. 0 VIT/'.L (Essential W operalions)
115 0 OFFlCw.. COPlES
I
116a NA1YlE OF PERSON COlvr:PLETIJ-.JG FORM
!
I :) 01\ f\u.. LQ,(\ 'hcJ't
16b DATE
3~31- [J
Ne....., Yan. Slat!::' J\rcl\lve~
GT'S:! (12'1U02)
9:1 7U!J:!~J 9:).-1'16 cae
feu t I