Box 33Records Inventory Data Worksheet Print Form
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
Government Agency `~ ~~ i ,1a ( ~ ~ Department ' A l~ ~ ~ ~,~~~
Record Series Title ~~ S ~ ~ ~,(, ~ i~6 S ~ YYl mQ rc.( e Q~ 6 ~. E'CO Yc~s
Date Span ~t-~S ~ ~, _ _ oZ Od~
Records Series
Description C
~~~~ ~~ eS ~ ~ ~ ~ ~ LL SI.t Yn rna-~
(describe content G'l n ~ ~~Gt~ ~ f~~
and characteristics
of records)
~° [~d~' J
{'' Alphabetical
~ Numerical
K-
Arrangement ~ Chronological
~"" Alphanumeric
(' Other (specify)
~"` Not Scheduled (~ ~-s
" Retention P eriod "~ b
J''CL
~
' Permanent -
Retention _ _ .
(' Historic
~ Scheduled Schedule # oZ ~y Schedule
Location r~
Format ~ Paper (".Audio-visual (`::Micrographic (" Electronic
Total Quantity ~ Cubic Feet: ~"' Items Amount: ~ ; Type of Items:
Annual
A
l
i ~ Cubic Feet Amount: ~~ __._ Items ~-
ccumu
at
on
Frequency of Use C` Daily (` Weekly {".:Monthly (` Seldom ("..Never
Restrictions on Use N/A
Records Are: ~-. In Poor
C
di
i ~„ Vital (Essential
i
O ~ Official Copies
on
on
t to
perat
ons)
Name of Person Completing Record ~ ~ (~ ~~
V Date ~~ f I r'
New York State Archives JCM (2011-01-OS)