Box 32Records Inventory Data Worksheet
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
!` Print Form
Government Agency '- -
_~n ~ ~ n
Pr Department
a~-e~ ~~ ~2.
Record Series Title
~
)S ~~.~>Jb Sumf?'1Cer ead~n ecdre~
Date Span S __ _ ~_ ~ Z oZdd
__
Records Series
Description ~dd ~ ~~~ s ~ ~}. 2 ~ ~ ~ 5u,m ~Ci Y
(describe content
h
d
i
i o~ ~~ (,~~ ~ ~ G ~ ~~Y'TJ
J
an
c
aracter
st
cs
of records)
~" Alphabetical
~ Numerical
gement ~~-
Retention
Chronological
Alphanumeric
Other
(specify)
Not Scheduled ~ ~~
Retention Period ~e.C
Permanent-• ~..__//
(" Historic
~ Scheduled Schedule # ast J Schedule ~~
~l _ _
Location ~-
Format ~_Paper (""Audio-visual ("'..:Micrographic {^ Electronic
Total Quantity ;~ Cubic Feet: (" Items Amount: ~ I Type of Items:
Annual -
Accumulation ~ Cubic Feet Amount: ~~ Items
Frequency of Use ~` Daily (` Weekly ("'.:Monthly ~ Seldom {' Never
Restrictions on Use N/A
__
___
Records Are: ~-. In Poor ~ ~.,, Vital (Essential ~ Official Copies
Condition to Operations)
-__
Name of Person Completing Record t Date
b ~~-, 14 . ~r--o w >n ~l ~ ~ r l
New York StateArchrves JCM (2011-01-OS)