Box 49
EOKC1<f
Records Inventory Data Worksheet
See instructions in Publication #76, lnvenwry and Planning, before completing chis form.
la. GOVERNMENT/AGENCY
-rOW{) of Wet
2, RECORDS SERIES TITLE
lb. DEPARTMENTIUNIT
t: iv vcr.FTa.
(, Cs-c;r ] Ii
.eo
doH
3, DATE SPJ\N
~O II
4. RECORDS SERIES DESCRIPTION (Describe content and characteristics of records)
Qo (l ~c..N{(\J &:>p/e..s e;: PO--tJ ~ ~ lIs
5, ARRANGEMENT
o Alphabetical 0 Numerical
o Other (Specify):
6a. RETENTION
o Not scheduled 0 Permanent
'Ft Scheduled retention:
~hronolo9ical
o AJphanumeric
o Appraise for historical value
b yvs
(dOlI.)
6b. SCHEDln...EAND ITEM NUMBER, OR.RE7I..SON.FOR.PROPOSED.RETEN1'lON
7. LOCATION
(Y\0 - \
Ca.V'r1u.Ja.fh
I ,C 5qr:J A
S, FOJY.1AT
liJ15aper 0 Audiovisual 0 Micrographic
g, TOTAL QUANTITY (In cubicfeet arnumber of items).
~ubicfeet: 0 Items:
o Electronic
I ()U 1-}..
10. ANNUAL ACCUMULATION (In cubic feet ar number of items),
jVlfJ.
Type of items:
o Cubicf eet:
o Items:
11. .F.REQUENCY OF USE,
o Daily 0 Weekly
12, RES1RlCTIONS ON USE
f\jA
o Monthly
o Seldom
~Never
RECORDS ARE
13. 0 IN POOR CONDmON
14. 0 \9J'AL (Essential to operations)
15, OOFFlCIAL COPIES
16b. DATE
Idb-o&{1
New Yor!: State lIrchives
GRS.2-(1212002)
92.79925 92.1~6 CDC