Intended primarily for distribution to public archival institutions, this sample questionnaire is designed to collect information on archival systems and services and related information on records management legislation or regulation. It is noted that the questionnaire is a simplification of a previous model and that it is being used for a worldwide survey of archival institutions by the United Nations Educational, Scientific, and Cultural Organization (UNESCO) and the International Council on Archives (ICA), as part of UNESCO's Records and Archives Management Programme (RAMP). A glossary of terms used in the questionnaire is provided, which is based on a final draft of a more extensive glossary also developed by UNESCO and ICA. Instructions for reporting statistical data precede the questionnaire itself, which has nine sections covering general information, legislation and regulations, personnel, budget, buildings and equipment, holdings, operations, services, and record centers. A 27-item bibliography of RAMP and related documents is also provided. (ESR)