Box 07
Records Inventory Data Worksheet
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
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Government Agency IZOuJlJ..OF-W ....i!PuJ6-.6g........ Department
Record Series Title L.Ll CClOtAJT.AELDI<J2S.. ...... .... ..._..
L....a QQ?:
Ig.~.CJ~~/~_n .QAl
Date Span
Records Series
Description
/J \ 'T U R. \.},
ReCORD DF IVV
(describe content
and characteristics
of records)
Arrangement c/
Chronological
C Alphabetical
C Numerical
C Alphanumeric
.'-
C
Other
(specify) I
Retention penodl
T 'I B_~
c
Not Scheduled
r
Permanent
Retention
C Historic
r
Scheduled
Schedule #
I~LZ!=L~:..m.d__j IschedUle
L
JI
Location
r Audio-visual ('Micrographic C Electronic
Format
Total Quantity
r.Cubic Feet:
r Items
Amount I
. Type of Items: I
Items t H
Annual
Accumulation
rCubic Feet
Amount: t..
Frequency of Use r Daily
r Weekly
("Monthly
C Never
Restrictions on Use Nt A
Records Are:
In Poor
r Condition
r Vital (Essential It}official Copies
to Operations)
.........
Name of Person Completing Record J
New York State Archives
'DDtJt0B UIJiJJ1Q:
: Date I
JCM (2011-01-05)
Records Inventory Data Worksheet
I P,ril)t:Forll1 ...~t
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
Record Series TItle
I..
I
TOLDtJ HOf_ 'H 'N-epUJ~tR.. Department
. HIt:tLt:I1..c___ ._e.AD&Q...9CL\. .. ..--.--.- ...
.u_ JlbT
I.gt&RfifD.Or;J
'--'
Government Agency I
Date Span
Records Series
Description
PRD&RAfn tl1FO: Tt\?'-~~~O~; QPP\\C.~-\~O()S,.
Cc:>(' \'Q. ~ 0 ndu'1UL ('E:.-. Spo:{S
(describe content
and characteristics
of records)
'-
C Alphabetical 60\1..\ .
C Numerical
Arrangement r Chronological
C Alphanumeric
C Other (specify) I
C Not Scheduled Retention periodl
C Permanent t yR- S
Retention ..... ...... _.._.-._---- . ._....__.~. ._--~--_.__.,- ,--- "- - . _. . _u._.____ .... .---- .-. -.
C Historic
C Scheduled Schedule # IL.fs_totf1---, II Schedule I j
. . .. . ~~. .....-- ~-_....-
Location ICARl \UJ~l1 J .
Format ~er r Audio-visual ('Micrographic C Electronic
Total Quantity C Cubic Feet: {' Items Amount I . Type of Items: I I
.. ...--_. ..~......
Annual C Cubic Feet Amount: l. . Items '--.-
Accumulation ._-. . -._-" .. ....-.-..... ... '.~ .. .0-' . - . n...~ . ----._-..--.
Frequency of Use {'Daily r Weekly (\Monthly ~dom ONever I
II
Restriaions on Use IN/A
--.--. . .- -.-.--..
Records Are: In Poor r Vital (Essential ~cial Copies
(' Condition to Operations)
Name of Person Completing Record I DDDnCk\..t"'~.V(r . J Date r HRc&.\ d.O'1 I
..
'-'"
New York State Archives
JCM (2011-01-05)
Records Inventory Data Worksheet
I~ ... P,rirrt:Forr:n~, ..~
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
.~
Government Agency I To W A.).. f)E_ u.1&PPJw-iR-
Record Series Title t._.. '8SCl/:lL__ltL --AJIS-----
L _~_QOu7
pltt<}L USE,
Department
L R__cJf.WTlO^-J
Date Span
Records Series
Description
PLfVYG-RlJUN!J C.Ofhm.
()/J Y
(describe content
and characteristics
of records)
.... n. ._"_.," ._.._..._____.. ....._____._._... ___._ ~___..____...._.... __n.', _. ..._.....__._ '_'__~'__""__"" ._ ._..______......._.._.....__.... . n. ._n_" ......_ _~..m.___._._.___.._"_.
.........
C Alphabetical
C Numerical
Arrangement f/ Chronological
C Alphanumeric
C Other (specify) ,
-
C Not Scheduled Retention periOdl
r Permanent ~ '/ fLS
Retention '"'_m__ _........,._...._w..._ _. n..___ -- -----..----,..--...-- - .-..- .. .-.--
C Historic
C Scheduled Schedule # 15_~f.~}:).1 ___J II Schedule L_____ --.I
_n _.___ _ --
Location I C&RUJ) ftr ~-
Format I~per r Audio-visual CMicrographic C Electronic
Total Quantity r Cubic Feet: r Items Amount: I : Type of Items: I
-..--- .- p-- .
Annual (': Cubic Feet Amount: I. __.1 Items 1_
Accumulation ..v._.._ ._--. m_.'_ __." .- --" . - ..' -...,.-.--..-..' .--".
Frequency of Use rDaily r Weekly ("Monthly 1~ldom ONever
Restrictions on Use IN/~..
-- --- -....-. -"-'. ,,_n" ..u___._' -- ,,---'--"-" ...-."...--...--." . "------_.......... . .".---
Records Are: In Poor r Vital (Essential COfficial Copies
r Condition to Operations)
Name of Person Completing Record I roV\f\(l~V\h([t -I Date IA0& h~OU 1
--
.~
New York State Archives
JCM (2011-01-05)
Government Agency I
Record Series Title I
Date Span '- .
'-'"
Records Series
Description
(describe content
and characteristics
of records)
Arrangement c?
.........
Retention
Location
Format
Total Quantity
Annual
Accumulation
c
r
Records Inventory Data Worksheet
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
P,ririHorm, ~,
L!<.f:.CR~710_AJ. .
o W,()0 E WI~PPuJ (ktf?.. Department
~
.-tJ
a 001-
SmPLO-Yct TtmEc5I-1t.~TS
c
~~,- ._~.__.. ".. --- -- -----"-.
Alphabetical
Numerical
Chronological
Alphanumeric
Other (specify) I
Not Scheduled Reten';o" period/
Permanent 1 \J P-S
(V aper
c
c
c
c
c
Historic
Scheduled
l5:L:?f:\ '11. . .' I Schedule
Schedule #
1C.~Rt\JU:>f\)n-1 ...
C Audio-visual ('.Micrographic C Electronic
C Items
Amount: I
. Type of Items:
C Cubic Feet:
C, Cubic Feet
Amount: I .
Frequency of Use C Daily
Restrictions on Use IN/A
Records Are:
........
In Poor
r Condition
C Weekly
(\Monthly
New York State Archives
Name of Person Completing Record
.--1
Id
I.u
ONever
.~.I. aOt
JCM (2011-01-05)