Box 46Records Inventory Data Worksheet
See Instructions in Publication +`76, "Inventory and Planning", before Completing Form
~ Print For;r
Government Agency I ~
~ ... Department
_..... _
.. ...... _..
Record Series Title
_. __ _
__.
Date Span
Records Series
Description
(describe content
and characteristics
of records) ~~,~ _. f ~ -~'[' ~ N ,/
[}-~1./ J / ~1.~
~~ ~ ~ ~ V ~~
t Alphabetical
~': Numerical
Arrangement r Chronological
(`: Alphanumeric
(' Other
(speciry)
etention ': Not Scheduled
_
;': Permanent
Retention Period
__.... _..._ _ _..-- .___._ ~
i Historic
~' Scheduled Schedule ~ ~ ~ Schedule ,
__
~
Location ~ _ ___ _
~V ~-
Format Paper ~" Audio-visual (",Micrographic ~" Electronic
'
I oral Quantity (" Cubic Feet: i Items Amount: ~ :
_ .. _. Type of Items:
_.
Annual
Accumulation
r' Cubic Feet
Amount:
Items I
frequency of Use ~' Daily {~ V~Jeekl
y ^
{..,Monthly
(`, Seldom
i
(':Never
Restrictions on Use IN/A
Records Are: In Poor
~ Condition Vital (Essential
~ to Operations) ~ Official Copies
Name of Person Completing Record I Date l ~ ~~'
Ne~fi York State Archives JCi~A (201 i-01-05j
