Box 35Records Inventory Data Worksheet
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
Print Form
Government Agency -'~~ ~~ ~ ~~ ~ ~"ICeY• Department a~ ~ j ~~~~1~ r
Record Series Title ~~ S ~ „k..~S ~ -f - ~ ® ~ j L ~ 5 ~~. +~
Date Span ~-5_ __ . ~'_ 'Z-~~ ( _.
Records Series
Description
(describe content
and characteristics
of records)
~ ; O
~ ~ (~~, j ~(~ '~
S:-~.~s
~eC?~'
-- ~-
(' Alphabetical f/
J
(~ Numerical
Arrangement (" Chronological
~"` Alphanumeric
~' Other (specify)
(" Not Scheduled /
Retention Period J/",yQ g
~"' Permanent ~~~{,,,,/// 1~~``--
Retention
~' Historic
Scheduled Schedule # ~(.~ Schedule ~-
Location I
Format ~$ Paper (` Audio-visual ("..Micrographic (' Electronic
TOtdl Quantity ~jCubic Feet: f" Items Amount: I .Type of Items: r
Annual '-
Accumulation ~ Cubic Feet Amount: ~~~~ Items ~~
Frequency of Use (` Daily (` Weekly {"`:Monthly {"` Seldom f"" Never
Restrictions on Use N/A
In Poor Vital (Essential
Records Are: ~"" (" ~ official Copies
Condition to Operations)
--- -
Name of Person Completing Record ~ f, r~ ~ ~ ~ ~ ~ ~ Date ~ 1 ~ ~ I~
New York State Archives ", / JCM (2011-01-05)