Box 06
Records Inventory Data Worksheet
1_p,rir!rForm::.:~
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
........
I Government Agency I TOLQIlJO f-- W/JPPiA.)ficg- I I Department Ij~~ ~/"?EtJ]] Q~r._
..... ..----.--
Record Series Title t ..A f~CLDcA.JT_f1.1:._CDa. OS
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Date Span L _aD Il)
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Records Series mJlLJoR. i A.J VOl.- ve () ,.
Description pCArC- " DO
(describe content
and characteristics
of records)
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c
Alphabetical
c
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Arrangement ~
Chronological
Alphanumeric
.'-"
c
c
c
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Retem;on penodl
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r
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Schedule #
1l,-,_-2-~ ~_n__. _. __I I Schedule
_ 11
Location
1 CA R0 L() f'\.nt
Format
~ aper
r Audio-visual ('.Micrographic C Electronic
Total Quantity
r Cubic Feet:
C Items
Amount: I
. Type of Items: I
Ln____ _
Annual
Accumulation
r: Cubic Feet
Amount: I
Frequency of Use r Daily
r Weekly
("Monthly
("JNever
Restrictions on Use
IN/A.
Records Are:
In Poor
r Condition
r Vital (Essential k-Imffi
to Operations) ....r...Cial Copies
.'-'"
Name of Person Completing Record
Date I vAl) ~JJ.O
JCM (2011-01-05)
New York State Archives
.....P,rint.Forql.. .~
Records Inventory Data Worksheet
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
~
Government Agency I To L.WO..6E...W f]PP, JJ~tR. :11 Department I .e~R.E&IJol!J....
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Record Series Title L._ ._I~..l1-1Lf;.]]Cf!M_f1Mf'[!
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Date Span L ..JO.tO...
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Records Series CDI1fJ... E SPO/lJfJc vet. (j.~Sict"l'T6;f)LLf /SJ..5H /1tJ6; ScU//I?
Description
(describe content f/C .
and characteristics
of records)
....... ....-... ..... ....- . . .- -..--. .---_..-,. - .......- .---._.---_. . .. .. ______ _.~__._ u_"." ".u ...-"---"'" ... .. ...... .-......... ...- ... - ....
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C Numerical
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Chronological
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C- Other (specify) I
C Not Scheduled Retention penOdl
l- Yr2 S ,.
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C Historic
r Scheduled Schedule # 1.__L.:(~~9~dd~i II Schedule I .-.......1
--~-- .--..--..-.--...-.---.-
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Format c~er C Audio-visual (',Micrographic C Electronic
Total Quantity C Cubic Feet: r Items Amount: I Type of Items: I
.-.
Annual CCubic Feet L :1 Items L._.
Accumulation Amount:
. .........,-..-., .--- _....._._.u. . . '- -.--
Frequency of Use rDaily r Weekly OMonthly cpeldom nNever
II II
Restrictions on Use IN/A. ..
_.__.____m___U""____" .- . ----.-- .... . ..- .-~... -,' -_. ... .... ...-." .
Records Are: In Poor r Vital (Essential COfficial Copies
r Condition to Operations)
Name of Person Completing Record lDDf\ oCt. . UOVtct _ ,I Date LAo.&-. L aOJ} . I
.
New York State Archives
JCM (2011-01-05)
'-
'-
Records Inventory Data Worksheet
I P.ri nt: FOrm , , J
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
~
Government Agency 11Ow/l,ofj 11t\f.)I1j:~tJQ.Q{ . 'i II Department V<q~(' ctLii:cu:)- --
.,.. .~ .. - ~.... .".'" ..
L, -
Record Series Title .sPEr;[,0L,.C_VeAJL.~.L --
.- .. .--.- ....--. "-"'-'--"'---~' ~___'_' ...._~~_..n_ ....-.-. -.. ......-_..... -- ".,-.-. --.....--.,-------.-'---.
Date Span L 0C)lP ,.
. ,--,.'.,-..- .__"_""_'_-'_'0 -...-. .... . ._..~ .-.. ..u.__. .....----...- ._._.u ......_... ..._---~_..'-.- .._.-..--"' .'"- --..-.,. .-....-- ___.._..'U
I fILES COAJT/t I AJ I JJ6- boc LJ Int=AJT/D /I 0 tU PlR -r/11 /J J IJ C-
Records Series
Description TD Pit A k.. UfE Cp/X If/A I IV I tJ~ PLAv6f<ou!JD/
I /
(describe content COrylrn'vAy
and characteristics
of records)
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C Alphabetical
C Numerical
Arrangement cV Chronological
C Alphanumeric
r- Other
'--
C Not Scheduled
r Permanent
Retention
C Historic
C Scheduled
~~
(specify) I
Retention pe"cdl
.t..__..Y ~...~.
Schedule #
L5.f..~]31- ._111 Schedule
.j
Location
CJtRl}Lt'~'TH -
~per C Audio-visual (\Micrographic r; Electronic
Format
Total Quantity
Annual
Accumulation
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C Items Amount: I
Amount I -
r Weekly (\Monthly
I'
Type of Items:
I
1.._..._
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Frequency of Use r Daily
tP Seldom
II
n,Never
Restrictions on Use 1~r.A.
Records Are:
In Poor
r Condition
'"'. Vital (Essential
\ . to Operations) C,Official Copies
'--
Name of Person Completing Record I '1"i)n rll .. _ \......Q.n \1OJ't
New York State Archives
:/Date I
'I
JCM (2011-01-05)
Records Inventory Data Worksheet
I P,ri iifForr.n: ' ',I
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
'-" Government Agency I -rOtDIUOF__Lul~PJ?UJa,.E:. p___' I Department LRe.CRc...ffi10JJ
Record Series Title
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aCOq- ,,0\0
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Date Span
Records Series
Description
,
(describe content
and characteristics
of records)
'-"
r Alphabetical
C/ Numerical
Arrangement (' Chronological
C Alphanumeric
C- Other (specify) I
r Not Scheduled Retent;on Period I
C- Permanent =t- YI< &
Retention .. .".--...-----....----.- .... . n.'_' ' , _._n__' ....-.--.. -.--",.-'. .- .-... _......
C Historic
C Scheduled Schedule # Ilj~~?-~_~3 __"II Schedule I -------- ---- ' ---I
-, -----
Location leAR t..) LU&11t -
Format .~per r Audio-visual CMicrographic C Electronic I
Total Quantity C Cubic Feet: (" Items Amount: I Type of Items: I
.. ,---
Annual C Cubic Feet Amount: L p-j Items 1m
Accumulation _ __H ....-... ---_. .. .. ~- '. .- ....--,-_...... .._-----_.-. . '_-0
~I 'II ONever
Frequency of Use ("Daily r Weekly C,Monthly r Idom
II II
Restrictions on Use IN!~
..... _..,-~.. . .. -.-----,-. " .....-.. . -,-.... - . -----._-~ ...- ,_n'. ... . .-.....-...-.... -
Records Are: In Poor r Vital (Essential (""Official Copies
(" Condition to Operations)
Name of Person Completing Record 1)()(\t)Qltnncst I Date I AUG- ,', \ ,ci.O I \ 'I
'-"
New York State Archives
JCM (2011-01-05)
Records Inventory Data Worksheet
I.~.." p,r.int;FOl1l1d,j
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
'-"
Government Agency t I~OW r0Db~~W~PP.IJ0G:~~~. 'I Department 1_.g~9~~Wll() f',.J
. .,." .......
Record Series Title I . ~l~/_'D&_ST-~p-p,
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Date Span L _~.c)\D. .
p- .. ._.u' _._~.... - _._. M' --.--....-.--......... _.._...___.n..'.....____.__u.____.____......_._..__.._____ --.-.-.-.----..------...---.-- --..---. ,- _no .----',..--'.
moG--~\ Stte~\S rO R- R-f:C(<.c ~TlD to l)tPf,
Records Series
Description
(describe content
and characteristics
of records)
... ......- .. ..... .......-...~..-._.. - __n_ ........-- . ~ .--- .~ ..-..-.._---...-.... ...---...-.-...-.-........ .,.--...---.... ~ . -.............- ...___U'_ _.-------.. --.-. ...-._'-'-~'-
C Alphabetical
C Numerical
Arrangement ('
Chronological
C Alphanumeric
r
Permanent
(specify) I
Retention ,enodl
t
YR.~
'-"
c
Other
c
Not Scheduled
Retention
C Historic
C
Scheduled
Schedule #
IIL-t'?~l___~M_.lschedule
.m. j
Location
Ic,A~
r Audio-visual ('.Micrographic r Electronic
Format
~r
Total Quantity
r Cubic Feet:
Items
I
t.....
Annual
Accumulation
CCubic Feet
C Items
Amount: I
Amount: I
. Type of Items:
Frequency of Use r Daily
(\Monthly
r Seldom
ONever
II
Restrictions on Use IN/A
Records Are:
In Poor
r Condition
1""' Vital (Essential
~ to Operations) Q)Pfficial Copies
'-"
Name of Person Completing Record
New York State Archives
'-" Government Agency I
Record Series lltle
Date Span
Records Series
Description
(describe content
and characteristics
of records)
Records Inventory Data Worksheet
'.. P,~nt:F{)rm ...J
See Instructions in Publication #76, nlnventory and Planning", Before Completing Form
I
I Department 1.I<6CCQ..Q-\:'\'OV'\.-
'\---
.aO\O- .un__ - ---------
C!,OPIES OF PAYRnLL 1(tG--\S:;CC.-R.S-UOT AJaOE1;J
foR. vAu 0 rT
I
C Alphabetical
C Numerical
Arrangement c:/' Chronological
'-"
Retention
Location
Format
Total Quantity
Annual
Accumulation
C Alphanumeric
c
Other
(specify) I.
Retention periodl.
\f~~'
c
Not Scheduled
i
c
Permanent
C Historic
._---- j
c
Scheduled
Schedule #
1~_~_):3~_'9:t_ ___ui I Schedule
C~Micrographic C Electronic
. Type of Items: I
t__ ___._
Amount: I
('Cubic Feet:
C Items
C Cubic Feet
Amount: 1_
Frequency of Use r Daily
r Weekly
OMonthly
nNever
Restrictions on Use N/A
Records Are:
In Poor
r Condition
r Vital (Essential 0=cial Copies
to Operations) ~
'-"
Name of Person Completing Record I D(:).,\,\<\o..., l.Q;{\Y\l =\
New York State Archives
P,ririHclfln~> j
Records Inventory Data Worksheet
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
'-"
GovernmentAgency IrOLDU Of-__W.JJPPtNlt:tR.. ; I Department
Record Series Title '-_G:RADrPflO&Q&m-- ______ m __ ____ m _____________
I aO ^
___ ____ _ __ _ ____oo___ __m__ILl_________ --- -- - --- -------- ---
LA 6(,B_ ~__A_D OJ0
Date Span
Record5 Series
Description
FILt [OAJT~/A.J//J6 /1Jf"o ~E:.L.I977AJ6-7fJ
HI f:l/ L
6-/21:.8 AJ W I\J Y 6P.tv AJT F (j ~ C;1 R./U LV Jfn-1 l f<j r
(describe content
and characteristics
of records)
,--" --~_.. "."..- - ---.-- ---- - ..... .- .._- .--
--~-
/ \ L
........
C Alphabetical ~
C Numerical
Arrangement C Chronological
C Alphanumeric
C Other (specify) I
-- - ..- . - .-- ----
C Not Scheduled Reteo_ periOdl
C Permanent 1- Yf5_ ~
Retention -- - -.---------. .. ---.-....- _n ----,.. . .~. "--.-- .-
C Historic
C Scheduled Schedule # 1.1~!-El~L ~'II Schedule I j
.-.- .., .. - ~ ---
Location lGl)RtJUj~TU
- --
Format ~per r Audio-visual CMicrographic C Electronic
Total Quantity C Cubic Feet: C Items Amount I Type of Items: I
.....-.. .. ._._ __ ..__..._.m..' .--.. ~." --.......- ..-....-.-.. ..
Annual C Cubic Feet Amount: L JI Items 1.____
Accumulation -_.-- ".,---.'~~-~--- .-----.- --..... _..'~-... . .... _..n__'_' ..-.'- _.._-~.__..
Frequency of Use CDaily C Weekly (\ Month Iy ~dom C' Never
II "
Restrictions on Use IN/A_...
.--_. ..--..----. -..- ._.~ -- ..-.-.-.--.-.......- --- oo .___...___~_. .--.. -..---..- .-._-_.~. --- .-- ._~...._... - ..' ~.. - -. - ...-.. ,-.--... -.- -- ._...._~. -'-' -.. -_.~.
Records Are: In Poor r Vital (Essential (?Official Copies
r Condition to Operations)
Name of Person Completing Record I banma. Ll\J1L baAV.. ; I Date I Au0. -cl. JOlt.
a - 0
- -
New York St te ArchIVes
JCM (2011 01 05)
~