Records Inventory Worksheet

County, City, Town, etc

Number

1. Department

Division

Section

2. Name and title of officer immediately responsible for series

4. Series number

5. Description of records series (content, purpose, by whom created, form numbers, etc.)

6. Earliest date/Latest Date

7. Records still being created?

8. Annual accumulation?

Yes ___

No ___

Cubic feet _______

9. Arrangement

Alphabetic by _____________________

Numeric by ______________

Other ___________________

10. Reference frequency (check, insert number, circle appropriate words)

______ times daily, weekly, monthly, annually for ____ months, years

Never after _________

11. If there are other copies of these records, including microfilm, identify them:

12. Relationship to other records series (indexed, summarized, listed, etc.)

13. Location of records (building, room, file section, etc.)

14. Volume

Cubic feet ______

15. Size and format of record

16. Type and quantity of file equipment occupied

17. Statutory or state archival requirements for retention

18. Suggested retention period with justification

19. Additional comments

20. Inventory taken by and date

Reviewed by and date

22. Appraisal

Confirms suggested retention period or

Substitutes the following:

23. Department head and date

24. Records Officer and date

25. Other local authority and date

26. State Archivist and date