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Box 36
Records Inventory Data Worksheet PrirrForm See Instructions in Publication #76, "Inventory and Planning", Before Completing Form Government Agency ~' l a~~ df: - ~ u~a _ -r n _e c- _. Department ~ ~ ~ ~ ~ i.c~ 1~' Record Series Title U ~ e Y~~ ©~ Date Span Records Series Description l~ ~ ~ (1 p r ~ ~ ` i"~ r ~~~ (describe content ti t i h d P G V ;n ~ ~ (L ~ , 2 ~ ~ ~0~~ J arac er s cs an c of records) ~ .% ~ ~' Alphabetical Numerical Arrangement (` Chronological (' Alphanumeric j^ Other (specify) (` Not Scheduled ` C ~~ f Retention Period ~ ~l~ J ("' Permanent ~~C Retention (' Historic Scheduled Schedule # ~~~ ~ __ . Schedule ~r Location ~- / Format ~p Paper ~"' Audio-visual {'`.;Micrographic (` Electronic Total Quantity ~ Cubic Feet: {"' Items Amount: ~ ~ i Type of Items: Annual Accumulation f--.Cubic Feet Amount: ~ Items ~~ Frequency of Use ~' Daily (`` Weekly (';,Monthly ~' Seldom ("':Never Restrictions on Use N/A Records Are: In Poor ~' Condition Vital (Essential ~ to Operations) .Official Co ies ~ p Name of Person Completing Record ~~ ~ ~ r~f^il `'~-.. ~ 1'-~ ~ ~ Date ~ ~ ~ ' J New York Stote Archives JCM (2011-01-05)