Box 195Records Inventory Data Worksheet Print-Form
See Instructions in Publication #76, "Inventory and Planning", Before Completing Form
',Government Agency -~ _~ ~ ~ t\ ~~
i _~ _~ 0'~ h __ _ Department ~ ~VY~~
Record Series Title (/`~ (J \ '
Date Span
Records Series
Description
(describe content
and characteristics
of records} @ ~~ ~ { (`t i ~\ (\
m~ '^ ~ b ~J ~ 1 ~ ~ ~ `~ ~ V~
~~ ~ ~ ~~ V 1
~ `~01 S
('_ Alphabetical
(^: Numerical
Arrangement ~ Chronological
(` Alphanumeric
~: Other (specify)
Not Scheduled
i
R
t
ti
P
d
(
Retention
~"': Permanent on
er
en
o
e „ \ ~ ~ ~
v
__ _ __
~;: Historic
~: Scheduled Schedule # ~~ S Schedule
Location
Format ~j Paper ~"; Au dio-visual ~'_Micrographic ~" Electronic
Total Quantity {'`Cubic Feet: ("' Items Amount:
_ Type of Items: ~_
_.
Annual
Accumulation ~-~-.Cubic Feet Amount: ~ Items
_ _.
Frequency of Use (`:Daily (`.Weekly :Monthly Seldom {"`.:Never
Restrictions on Use N/A
Records Are: ~-. In Poor
Condition ~,., Vital (Essential .Official Copies
to Operations)
Name of Person Completing Record ~,~ ,i~` ~ w~ -Z~~. Date ~~ ~ `~
New YorkSiateArchives J 2011-01-05)
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