Box 50Records Inventory Data Worksheet
Pi
See Instructions in Publication ;=76, "Inventory and Planning", before Comp e , orm
Government Agency
Record Series T'`I
~'[
Department
1..._
i~ e
Date Span f ~
Records Series
Description
(describe content
and characteristics
of records)
~.
C~2s ~ ~ z ~ Zo 1 t
B ~ c.< <2~e pc~l-s
5 b~-'r~ t-14 ~"y
5 (~~ f
~ r~S
~': Alphabetical
Numerical
Arrangement ~ Chronological
QS
1~
(` Alphanumeric
~' Other (specify)
Not Scheduled
Retention Period '~
t" Permanent
Retention I _ _.- ~-_
___
...........
t Historic
~: Scheduled Schedule ~ Schedules
__. __
_.._ .
Location
i
Forma*. Pa er
p ~" Audio-visual ,'^:~iticrographic (' Electronic
,.
Total Quantity {" Cubic Feet: ~' Items Amount: ~ - I
i ype of Items: I
__.. ,
Annual
Accumulation r' Cubic Feet Amount: Items
I I
__ _.
Frequency of Use a~' Daily (` Weekly I (',:Monthly ('.Seldom
(':Neer
Restrictions on Use ~N/A
__
Records Are: In Poor Vital (Essential
~ Condition r to Operations) i~filaal Copies
Name of Perscn Completing Record
Date
Ne~r~ York State Archives
JCM (2011-O1-OS)