Box 47
Records Inventory Data Vvorksheet
See instruccions in Publication 4/76, lnvEnwry 8m)P18/J{Jing, bef or~ completing thjs form.
~x
4,
la. GOVERNMENT/AGENCY
1b. DEPARTMENTIUNIT
~-
2,
a.D \ \
4. RECORDS SERIES DESCRIPTION (Describe content and characteristics of records)
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~~O\l'\
D~\--
~w'L;n./
L>\-L
L\-
~ 1)\ \
--
,..--
~'D~
5. .ARRANGEMENT
o Alphabetical
o Numerical
~ronological
o AJphanumeric
o Other (Specify):
6a. RETENTION
o Nm scheduled 0 Permanent
~duled retention:
\; ~~
o Appraise for historical value
6b. SCHEDtn...EAND ITEM NUMBER., DR.R.EhSON.FOR.P.ROPOSED.RETENTION
'\\\v - \
~ ~ '5~:J ~
7. LOCATION
B, FO~T
o/"aper 0 Audiovisual 0 Micrographic 0 Electronic
g. TOTJ\L QUl\N'TITY (In cubic feel ornumber of items),
~iC feel: 0 Items:
10. ANNUAL ACCUMULATION (In cu I feel arnumber of items}
Type of items:
o Cubicfeel:
11. F.REQUENCY OF USE,
o Daily 0 Weekly
]2, RES1RlCTIONS ON USE
~\A-
o Items:
\0
A
o Monchly
o Seldom
~/er
RECORDS ME
13, 0 IN POOR CONDmON
14. 0 ytTAL (Essential to operations)
15,4 OFFICIAL COPlES
16a. NAME 0 ON COMPLETING FORM
...
l6b. DATE
GRS-2{12!2002)
E::l..79!l25 92~lqf, CDC