Box 42 (2)Records Inventory Data Worksheet
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
Government Agency p~.n ~ WQ i>n~~r Department ~~„~ ~' ~~,~ ~
Record Series Title
Date Span ~ 3 ~ ~ ~~~
Records Series `~ / LL f /l~ ~
Description
s ~
~ ~ ~ ~ ~ ` ~ j~ S r ~~e ~ ~S'
-{- dJ
(describe content ~- ~
and characteristics
of records)
-.:.~
~" Alphabetical
~ Numerical
rrangement I(` Chronological
Retention
{": Alphanumeric
(' Other
PrintForm
~ Lja,
(specify)
Not Scheduled
Retention Pe
{"' Permanent
(' Historic
~ Scheduled Schedule #
Location
(~ Y 2 s ~~~ a~»
'a Schedule
rnv
FormatPaper (`.Audio-visual (^ Micrographic {^ Electronic
Total Quantity (~ Cubic Feet: ("' Items Amount: ~ Type of Items:
Annual
Accumulation ~ Cubic Feet Amount: ~ Items
Restrictions on Use ~N/A
_ _ _._.
In Poor Vital (Essential
Records Are: C (' ~ Official Copies
Condition to Operations)
Name of Person Completing Record ~ ~~ ~ ~ ~~ ~ ~ Date ~ ~ f ' f
New York State Archives / JCM (2011-01-05)