Box 08
Records Inventory Data Worksheet
P.rint.Fon:n....j
See Instructions in Publication #76, "Inventory and Planning", Before Com pie
'-'
Government Agency /70wD. OELJj~PBllL!.ctt.g". .
Department
Record Series Title
Date Span
Records Series
Description
(describe content
and characteristics
of records)
r
Arrangement 0=
c
c
.........
r
c
Retention
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Alphabetical
Numerical
Chronological
Alphanumeric
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(specify) I.
Retention PeriOdl
l-ye6
Not Scheduled
Permanent
C Historic
c
Location
Format
Total Quantity
Scheduled
I Li SS{:t--=J I Schedule
. '. .1
Schedule #
f\J nL
C Audio-visual CMicrographic C Electronic
r Cubic Feet:
r Items
Amount: "
, Type of Items: I,
I
Annual
Accumulation
('.Cubic Feet
Amount: I
('"Never
Frequency of Use r Daily
Restrictions on Use IN/A.,
Records Are:
In Poor
r Condition
(' Weekly
CMonthly
Date I Aur; I d. D .
JCM (2011-01-05)
New York State Archives
'-" Name of Person Completing Record
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Date Span
Records Series
Description
(describe content
and characteristics
of records)
New York State ArchIVes
Records Inventory Data Worksheet
I .' P.rint'Form.... J
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
I.. RcL-c, \<<"0,.:\\ n. 0..
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Department
r Alphabetical
C Numerical
Arrangement C Chronological
C Alphanumeric
C Other (specify) ,
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C Permanent ~ .\1r~.'.
Retention ..- '.- -,-.--_.... .. ,__.n. .-... .~., - .. ..-.. ----
C Historic
C Scheduled Schedule # 1.~_.LW.s}...._J II Schedule L. ..j
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Total Quantity C Cubic Feet: r Items Amount: I Type of Items: I
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Annual C Cubic Feet L ..1 I
Accumulation Amount: Items
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Frequency of Use ('Daily C Weekly () Month Iy ~eldom o Never
Restrictions on Use IN/~.
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Records Are: In Poor r Vital (Essential 06mCial Copies
r Condition to Operations)
Name of Person Completing Record I tDr\Y\CL ~ohccr c I Date lJ\ua.a'l~ov .
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JCM (2011-01-05)
Records Inventory Data Worksheet
P.rint-Form. J
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
'-"
Government Agency 1_ _ ..
Department l.fu('(!J)fioo_
Record Series Title
.-..A C~j.DEA..J:t__Jl ;;'''QRQ_S>_ ---.-- --- .-------
Date Span
L_
.... . _ _ _ ___ _ ~.O Q~3- __m__...______.___._____...._ ,. __.____.____ __ __ _ _____ ______
REC.ORD O~ ItJ.) U r.z ~e.S- /lJO (111 fUOA. S
Records Series
Description
(describe content
and characteristics
of records)
C Alphabetical
C Numerical
Arrangement C Chronological
C Alphanumeric
C Other
........
C Not Scheduled
C Permanent
Retention
C Historic
C Scheduled
....----.---..------.....-----..-- --._~\ -.- ----.... .--.---...--........
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(specify) I
Retention periOd/
_1..._Y~?
Schedule #
t_~~~~L~__---_JII Schedule
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Location
ICaCf)l;JQ,~ ..-
Format
rvPaper
C Audio-visual GMicrographic C Electronic
Total Quantity
C Cubic Feet:
r Items
Amount; I. .
Type of Items:
I ........ ___ __
I- __ ___ _ _ ._ _ __
Annual
Accumulation
r, Cubic Feet
Amount: L
__ ; jltems
Frequency of Use r Daily
C Weekly
OMonthly
IQ"-ieldom
CNever
I
Restrictions on Use I.N/A.
Records Are:
In Poor
r Condition
r Vital (Essential@tSffi."cialcopies
to Operations)
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Name of Person Completing Record I'D OD1\ct_Lq.QhC\ft_
New York Srare Archives
___._ :/ Date I ~L?Q- ~1 l{).\L ._1
,J I JCM 2011-01-05
Records Inventory Data Worksheet
P,ri rrU=orm : J
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
"-'
Government Agency 110 wCLof -Leb."
C Alphabetical GOIL\
I
C Numerical
Arrangement C Chronological
C Alphanumeric
C Other (specify) I
- -
C Not Scheduled Retention p,nodl
(' Permanent t yO-S
Retention .- -- _..------.~ .- .,__.._~. ____~___._.__ 'U_' _....___.____. ..-. -..-........ ~ .... 0_.__...._.._,_,... _..._.n.
C Historic
r Scheduled Schedule # 15~_E ~131-.._:11 Schedule I il
'---.~"-""" --. '-'.. -.- ,-.-.-.-. ---.--....:
Location ICJ1[\t0W~nL
Format cA'aper C Audio-visual ('.Micrographic C Electronic
Total Quantity C Cubic Feet: C Items Amount: I . _ .. ____, I Type of Items: I
-..-..-....., .~- ,,-, .--....----.--.
Annual (',Cubic Feet I -J lltems L__.. ._______...___._1
Accumulation Amount:
.--- .~ -" ---. .. ....___.._ _m_ -.....--.-.-.-- _."-'-,- --..---...--.
Frequency of Use ('Daily C Weekly ()Monthly ~Seldom ONever
Restrictions on Use INI~_ ----I
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Records Are: In Poor Vital (Essential ~Official Copies
r Condition r to Operations)
Name of Person Completing Record I ~{\(\Q,. _4D\'%J-_ j I Date I-AUq.J,~o.~/. I
... .._n_,_ -.-.
-
Record Series TItle
Date Span
Records Series
Description
(describe content
and characteristics
of records)
"-'
'-"
New York State Archives
L/(Q.c.{'Q.O.:
Department
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JCM (2011-01-05)
P.rint'Form ~ J
Records Inventory Data Worksheet
See Instructions in Publication #76, "Inventory and Planningft, Before Completing Form
Record Series TItle
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Department Ltt~.rtCl:DIQ.YJ.. _
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Government Agency t.1'~f1 oflJ.Ja. __ _l~/]_
Date Span
-,- -~_.... -_.__.~_. ~._..-._--._.....--- .--....------.--..-..-..----...- .-. -~.~--- "--- ----.......-.
Records Series
Description
(describe content
and characteristics
of records)
__ P___ _,_",____,_.__" _.__...,._.___.. _~___.__ ._ ...._____.__. __,,____. .__.______.__.___.__ __._______.__n.._.. "_'n ___n._._______._.__.__'.. .----~,-.--.._..-.
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Ie Alphabetical ()
C Numerical
Arrangement C Chronological
C Alphanumeric
C Other (specify) I
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C Not Scheduled Reten';on pe'iodL
C Permanent 1 "i QS
Retention - -...--- --- '. ......--.... .- ----. .... -.-._" _ u._
C Historic
r Scheduled Schedule # I.~ '~ia~!?_LJII5chedUle l_ j
---- .- ...
Location 'ri1l'.{lWCl~ ....
Format ~per r Audio-visual CMicrographic C Electronic
Total Quantity C Cubic Feet: ("'.Items Amount: I Type of Items: I
.-.-..--.--.-.-.... .---...... - ...-- ..~ -. - --
Annual t' Cubic Feet Amount: L _._._ .----..._..1 Items I
Accumulation . -,-- _..~ -. -... . - . -... ~. .. ...._--.. ...- - . _~._u
Freq uency of Use CDaily r Weekly (\Monthly tfeldom ONever
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Restrictions on Use I.N/~_...__.
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Records Are: In Poor r Vital (Essential ~fficial Copies
r Condition to Operations)
Name of Person Completing Record I ~(l")'LNl- UJh . III {} ft\}. - ~ I Date I <...j 11 C _.. cl rlDJ/
u -
New York Srate ArchIves
JCM (2011-01 05)
'-"
Records Inventory Data Worksheet
I . _ P.rint'Fo~~__J
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
Government Agency Itc.v....)10_0 E._W.OPPuJ&& ..__ i Department
Record Series Title L._B.tc..f;Lff?_.._
L... ..~CO~1: - .. ....___.__.__.________._.._._____ .-.-
LRcCRWTIQrY
'--
I Date Span
Records Series
Description
{) c. ct,. PT~
P L /v'l fj-(.l. 0 UAJ D f( <-
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Vi
(describe content
and characteristics
of records)
'--'
C Alphabetical
C Numerical
Arrangement C Chronological
C Alphanumeric
C Other (specify) I
. ._.,,-,_.'
C Not Scheduled Retention periOdl
Permanent 1- \f Q.S-
c
Retention .--.--.".'---- 0____._''" _u .__ - . -~_. -~ ~ --.--..--..-- ._._....__.___...n _.-- .-..-. - --..-.........,...-
C Historic
r Scheduled Schedule # I'n:_ fJ<O ~3.___. ..'11 Schedule I j
---_.."-- . ._- -. ..
Location ICAL< AJuJ ~Ti J_.
- .
Format ~aper r Audio-visual (\Micrographic C. Electronic
Total Quantity C Cubic Feet: r Items Amount: I ._.: I Type of Items: I I
_.--'--. .. .............., .. .--.-
Annual C Cubic Feet Amount: I _.1 j Items L.. .m...1
Accumulation -- -----. __. ....._,..' ._____ ,,'_..__m ....--.,- -_.'~ .. - _'m . .._-_._.---~.- ..-...
Frequency of Use rDaily C Weekly ()Monthly I~dom ONever
Restrictions on Use /N(A .H_UH __ .H__ ._1
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Records Are: In Poor r Vital (Essential ~cial Copies
C Condition to Operations)
Name of Person Completing Record I bOJl/bJL )~Y.- ; I Date I I(} J Jt) .;2. J(J 0..
---... n
0 1 - -
"-'
New York State Archives
JCM (20 1 D1 05)
Records Inventory Data Worksheet
F>,ririH.orm _ _ j
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
Date Span
Government Agency LTQ WAJDE__u2t1PJ~JJJ.JfreB,i Department ________.___.
Record Series Title L_ 6>r1-u'",,_~mDC__m_eBl:>'(lB:/Jf!"!_m__.m_______________. .... . ..__ __ ______
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Records Series
Description
(describe content
and characteristics
of records)
L_
C Alphabetical
(' Numerical
Arrangement ('
Chronological
C Alphanumeric
...........
c
Other
(specify) I
Retention pe"odj
t 'IRS
c
Not Scheduled
c
Permanent
Retention
C Historic
r--.
\ .
Scheduled
Schedule #
II E _ _ ,,/schedule
_ ..' .5lp3_ .
L mm ___m_ ._ __ _. j
Location
Ie f}R.t0W~l}t__
Format
~per
C Audio-visual (\Micrographic C. Electronic
Total Quantity
C Cubic Feet:
r Items
Amount:',
. Type of Items:
Frequency of Use r Daily
C Weekly
('"Monthly
Items
I
L_______
Annual
Accumulation
C Cubic Feet
Amount: L.__
(\ Never
Restrictions on Use
IN/~.
'. _ .._.. ..___.~ _._...._ uo.. ___ _.. _....._._.. ..~._~~...... ..._. .__ "....__.._...._ __ ___...__........ __..
._~~.._-
Records Are:
In Poor
(' Condition
r-- Vital (Essential ~. Ie'
\ . . cia oples
. to OperatIons)
New York State Archives
I.Au
'-" Name of Person Completing Record