Box 38Print Form
Records Inventory Data Worksheet
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
''',~'~ j ,, ~ ~ _.__
',1 Department ~ WC f ~ ~
Government Agency ~ D ~~ n ~ _ IN ~' 1(I C e (~
Record Series Title
Date Span _
Records Series
Description
(describe content
and characteristics
~ of records)
~~~5 ~k~ ~61b Sun~rnari~
~ ~2aG~~~~ y~e.~6r-~S
~ Alphabetical
Numerical
t
,rrangement {"` Chronological
~ Alphanumeric ~--
~^ Other (specify)
~^ Not Scheduled ~ ~ ~~~ ~ ~6
Retention Period
~^ Permanent
Retention
~- Historic
( ~ ~~ Schedule ~~
Scheduled Schedule# I o<~
~ -~
Location ~r
.:Micro ra hic ~"` Electronic
Format l~ Paper (" Audio-visual ~' 9 P
T e of Items: ~-ter
Total Quantity ,Cubic Feet: {".Items Amount: ~ yP
Annual , Items
{t~CubicFeet Amount:
Accumulation :Never
Weekl ('.Monthly (` Seldom ~`
Frequency of Use ~' Daily (" y
Restrictions on Use N/A
Vital (Essential
In Poor ~. (` Official Copies
Records Are: ~ Condition to Operations)
i~ 0 ~ .(` Date ~' ~ ~ ~ ~
Name of Person Completing Record ~ ~~ ~ - JCM (2011-01-c
New York State Archives