Box 03
Records Inventory Data Worksheet
- ~J~~Ilt~
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
Government Agency I TOw .0-:--
Record Series Title I
L
Department
IBC~6~ndAl.
"-"
Date Span
Records Series
Description
(describe content
and characteristics
of records)
J2.
_N
S Pee-tAL .- -\JE.
..a0CB____n. .----
frLt~ CoN\".A-\tJitJ6. l)ocu(Y)cf0TAllOO Or-
~c c \ A L E'\tf. f01S/PArzk.. USe) [lUaU D I tJ C-
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L.
_..____ ____~..~._.__.__. ,..'m...__ __ _~_ ___ _.. __'- __.________"_"___ _.,. ..__..__._ ___,.._ _.._-_..~-_ ____,_w_...." .._.._.... ._______._.m. .
C Alphabetical
C Numerical
Arrangement V
"""
Retention
Location
Format
Total Quantity
Annual
Accumulation
Chronological
C Alphanumeric
c
c
Other
(specify) I
Retention Period I
1- YR. ~
Not Scheduled
c
Permanent
C Historic
c
Scheduled
Schedule #
15__~_~~:J~=' I Schedule
I :1
__._.____. ..___._.._.___.m_.._._ ___ .___....___.__~~:
ICP\R\\)W_~-W ..
~. aper
C Audio-visual ('",Micrographic C Electronic
C Cubic Feet:
C Items
Amount: I
. Type of Items: I
L
C Cubic Feet
Amount I
o Never
Frequency of Use r Daily
r Weekly
OMonthly
Restrictions on Use I.N/~..
Records Are:
In Poor
r Condition
JCM (2011-01-05)
Date l~vG t ~6 / ld
New York State Archives
Name of Person Completing Record
'"'"
Records Inventory Data Worksheet
I.. . P.drrt:Form :J
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
........
Government Agency ITO . U. .().ELD(1WI~R.: Department IB?~gt~jJ()iJ
I.. ...It Q)t..~ :..~r::.~._......- ...-----......-. .--.-.---.--......-.-.--...-..-... ....---.-..-........-
L. . '~() O~ _._ ._d., ___.__._
[. (fl PLD\/ CC
Record Series Title
Date Span
Records Series
Description
I, f'r\c 51-\ e: ~\S
(describe content
and characteristics
of records)
........
C Alphabetical C/
C Numerical
Arrangement V Chronological
C Alphanumeric
C Other (specify) I
e- Not Scheduled Retent;on pe';Od! ~
~QS
c Permanent
Retention . - ,-,,~"... ___.n._.' .__ _n__.. ...........-....- -.-
C Historic
C Scheduled Schedule # 15 J f:;R~3.... .! II Schedule 1.___....-.-.. ..1
.-....
Location ICA~J\JW~tt\.
Format n Paper C Audio-visual ('''Micrographic C Electronic
Total Quantity C Cubic Feet: r Items Amount: I . Type of Items: L
...----
Annual nCubic Feet Amount: I -..-.j Items I
Accumulation . . -.... .........,.... .-_..~.-- .... .- . m .___" . ._. .. ..----------.-.-.'-
Frequency of Use (' Daily r Weekly nMonthly ~eldom CNever
Restrictions on Use IN/A I
.-. .. __ .___.._ ._._"..._ .....__.n...'..~ _
Records Are: In Poor r Vital (Essential COfficial Copies
r Condition to Operations)
Name of Person Completing Record Illn. -_. ~ ^ 1 r - i r.r~ :1 Date I J\UlfJ~~1l [
II HW '\U ...~)lWV\I.. ... .. .
New York State ArchIVes
JCM (2011-01-05)
........
Records Inventory Data Worksheet
I- . P'rlnHorrn> 21
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
......
Government Agency h-OW() 0 t.j-u_~_E_PJt0(l-6R Department I __B.~_~8c.&})QtJ
-- .' . _..-...~ ....0 __.__', _'~ ---
Record Series Title 1.A_illU.J1C.___PRQ&RB(D~
......- .-' 'M_ _.__.._._.._, ._....~- . ._----,_.... --""-'-'--'~-. .. ....-- '"" -~.....__..- ..-. u_. ...--....---. --- -
Date Span I. a Dtfl1
. - -...-.....- . n_.._. --.-_.. .'.0' n._. ..-_.. .-.--- _.~ '._--" -,.....--_.__.. -.......-.-. .. ,"--'.-. .-.".- '-'_.~-_.~-..__. "..-----'. .-. ......-._..
r
Records Series PAC)6-AAm l~rO~ Tho..{\):.. 4 tluS i G.-ppl\ca..-t) o()~ ) c..<){,'f'Q, ~p:Ytk.'('(.Q l
Description (} y rn Oo.~-nC ~ i ~ <2. \d ",\ ~ l q:\ c..
(describe content
and characteristics
of records)
----- _._u. -.--.... . .__._.n.'. ..--.---..... __m_ u'_'" ..~..__ .0"._' . .-_......... ..~..,---.-. .. - -~. .- _"__0" ..
C Alphabetical
Arra ngement c/
Chronological
C Numerical
C Alphanumeric
c
Other
(specify) I
Retention Period I ~
1
'(Q5
........
c
Not Scheduled
('
Permanent
Retention
C Historic
c
Scheduled
Schedule #
Ll:_f~q~__.
, I Schedule
--./
Location
leA Rw wf'l}l
Total Quantity
C Cubic Feet:
r Items
Amount: I
I
L..__...
Format
r JM'Per
C Audio-visual ('Micrographic
Annual
Accumulation
CCubic Feet
Amount: I
Frequency of Use r Daily
r Weekly
(',Monthly
CNever
Restrictions on Use I.Nt.~.. '
Records Are:
In Poor
r Condition
,.. Vital (Essential ./
\ (?Official Copies
. to Operations)
...... Name of Person Completing Record
'Date Id <6d- \ --1
New York State Archives
JCM (2011-01-05)
Records Inventory Data Worksheet
p,rirlt~Forr:n,:J
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
'-'
Government Agency ITQ W,t;), ,OJ=",WAJ>Plf0CLcSg, Department 18 c.cvQ E:: ~T\O to
.... ."-.~ ',_,_,"n."_'_' ,--.- _n.._. _....n... -.-......
Record Series Title Ij~,L~~____ .C.HJ1\,S-rroI",S LlJ~_G'tL"
-, -, n_..._u___. m .____n_n___ _.___ __ .__ _n_._ ._.._........_._.._._ -.,.-..- " --.'..
Date Span L, ()O 0 -~-
.-...---.--_. " ..~_... .. - -------....- ."---- ._~. _m_...._____.__... -- ..-- n_.n -, --..------.--......---.-.. -..-..,.....--.--.-.- -.....-- -.-.__........._- .- ...~-.-_..__... .-....
.A LL i t.J FO tPE-RTA IlJ I fJ 6- \D T>--\ C Jl oovt
Records Series
Description
(describe content
and cha racteristics
of records)
-- .'.- _..m___._..' ....-.-., ...._ph._ .-.....-......-.-- ..._----~. _.. .....__. - .... uu_,_,__"'_'" ._n..'u__..__.,_..___..____._.. ~~
....-.-;-....................-.--......--......-...-....... .... ........-.... '--. '---'-'
c
Alphabetical
//
/ ~O \ ~
C Numerical
Arrangement V
Chronological
C Alphanumeric
c
Other
(specify) L
Retention periOdl
t
YRCS
'-'
r
Not Scheduled
r
Permanent
Retention
C Historic
r
Scheduled
Schedule #
15t?I_~,_,__' I Schedule
I 'I
......---.-.- -- .-.---.--.---. ._--~.._~~--
Location
I CARt0ujfi.)Tt\_
Total Quantity
r Cubic Feet:
r Items
Amount: I
I
tuP'" ,
Format
. aper
r Audio-visual C,Micrographic
Annual
Accumulation
C Cubic Feet
Amount: L
Frequency of Use r Daily
C Weekly
("Monthly
4peldom
nNever
Restrictions on Use
INIA
Records Are:
In Poor
r Condition
l Vital (Essential p6fflcial Copies
to Operations)
"--' Name of Person Completing Record I
New York State Archives
Date I J\,U&.J c1() II
JCM (2011-01-05)
'-"d. GOVERNMENTI AGENCY
Records InventoIY Data V,Torksheet
S~..., 'i1SlrUc;UU"', in l-'ulllit:iJtiulI4J76.lllvl:lIWry.. aUll PJiJlII/II'fj. bdul'~' c.:ufllplCLillfl chi!. rurrn.
lb. DBPARTMBNTIUNIT
<L ~\Q...o... ~ C (\
s
3.
4.
(De.<;criue (;OmenL unci churucteristiC5 or rl:!cords)
.
10 ~()ACHASES'. 1~.hJOlCtS
I
~~
./ ----
5a\~
5. ARRANGEMENT
o Alphabetical 0 Numerical
Gl'Chronologica\
o Alphanumeric
o Other (Specify);
60. RETENTION
o Not scheduled 0 Permanen:
~chedu\ed retention:
o Appraise for historical value
'--"
1- '1tAR<V
6b. SCHEDULEJ\.ND ITEM NUMBEP... OR.REl\SONFORPR!JPOSEDRETENTlON
.. l. [559]
7. LOCA nON
C.ARrUwAT\1
8. PORMAT
)6 Paper 0 Audiovisual 0 Micrographic 0 Eiecuunic
9. TOTAL QUA.N'IITY (In.cubic feeL ornumuer oriLBms).
o Cubic feeL: 0 Items: Type or items:
10. ANNUAL ACCUMUlATlON (In cubIc leel arnumber 0 il.ems),
o CubicleeL:
o items:
11. .FREQUENCY OF USE:
o Daily 0 Weekly
]2. RESTRICTIONS ON USE
o Monthly
Q{Seldom
o Never
-
RECORDS ARE
\13. 0 IN POOR CONDITION
14. 0 Vrr}J.. (Essential to operations)
I
115, -POFFlClALCOPIES
~ 16a, NAME OF PEF..50N COMPLeTING FORlvl
on f\(}.., Lt.:0ho.rt
16b. DATE
-\-l \
GPS 2 (12.-20021
9~79!1:!5 9::<<46 roc
Ne... Y ori: SLate l\fcluve!i