Box 34Records Inventory Data Worksheet Print Form
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
Government Agency ~ ~~ ~ I ,1 l~ ~
W Department ~~ )~~^
~ W(.Q.~ ~ I J~ C~~
Record Series Title ~ 15 Q s ~ ~ Z {~ ~ !..-~, ~ {~
Date Span ~~ S ~ ~- Z ~~ Q
Records Series
Description
~~ ~ Q ~ j Ll ! rl~ rrn ,2{~~'~ f S ~ ~~'"LC-e-~J~
(describe content
and characteristics
of records)
~" Alphabetical J,{
Numerical
Arrangement (` Chronological
~~
(" Alphanumeric
(' Other (specify)
~"' Not Scheduled /:
~S
R ~
tU
{" Permanent etention Period ~ eC 2d l l[7
Retention
{' Historic
~' Scheduled Schedule # ~ ~ Schedule I
Location
FOrmdt ~` Paper ("'Audio-visual (' Micrographic ~` Electronic
Total Quantity ~ Cubic Feet: {`' Items Amount: ~) Type of Items: ~~
Annual
Accu
l
ti
~ Cubic Feet
Amount: ~~
Items
mu
a
on
Frequency of Use (" Daily (' Weekly {' Monthly ('' Seldom
(":Never
Restrictions on Use N/A
Records Are: In Poor
~ C
di
i Vital (Essential
~
~ Official Copies
on
t
on to Operations)
Name of Person Completing Record ~ ~, ~ r~ ~ ~ ~--~~~ Date ~ J; J ~j
ivew rorKSiateArchives JCM (2011-01-05)