Box 41Records Inventory Data Worksheet
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
'Print Form `
Government Agency ~ ~ ~ e Department I ~~~ r ~ S-~'L~°d^
Record Series Title
Date Span
Records Series ~ f ~-~' ~
Description
(describe content ~ ~ ~~ ~~ i
~~.- ~~ ~
~~/~
' J-~-S
-
~ l ~
C~
and characteristics
of records)
~' Alphabetical
(~ Numerical
rrangement I~" Chronological
~" Alphanumeric
~" Other (specify)
~"'. Not Scheduled ~ e~
Retention Period ~ l n
~" Permanent ( K
Retention
{' Historic
Scheduled Schedule # ~~~ Schedule ~-
Location ~- ~ ~'~} (~'
Format ~`_Paper (`Audio-visual ('.Micrographic ~"' Electronic
Total Quantity {":Cubic Feet: (" Items Amount: ~- Type of Items: ~-
Annual Cubic Feet Amount: ~~ ` __._ Items
Accumulation
Frequency of Use ~` Daily (`` Weekly (";Monthly (' Seldom (":Never
Restrictions on Use N/A
In Poor Vital (Essential .Official Co ies
Records Are: ~" t" ~ p~
Condition to Operations)
Name of Person Completing Record ~ ~ ~ ~ ~ `~ ~-~ ~ fl Date ~- ~' ~ ~~
New York State Archives JCM (2011-01-05)