Temporary Custody Receipt Form - Monroe County History Center (Page 2 of 2) in pdf

Temporary Custody Receipt Form - Monroe County History Center Page 2

Brief description of objects:_______________________________________________________

_____________________________________________________________________________

Time period of the objects:________________________________

When were the objects acquired?___________________________

How or from whom were the objects acquired?________________________________________

______________________________________________________________________________

Condition of objects:_____________________________________________________________

How do the objects relate to Monroe County?

_______________________________________________________________________

______________________________________________________________________________

Any other comments regarding your potential donation:_________________________________

______________________________________________________________________________

Temporary Custody Receipt Conditions:

•

The Monroe County History Center (MCHC) acknowledges receipt of the item(s) listed for

acquisition review by the Collections Committee. Object(s) listed on this document are for temporary

custody at the MCHC. If items are accepted for collections, “Deed-of-Gift” forms listing the

accepted material(s) will be mailed to the donor for a signature to complete the donation process.

•

Items not accepted into to the History Center’s collections will be returned to the donor or included

in the Monroe County Historical Society’s benefit sale or auction.

•

Should the item(s) be returned to me if the MCHC does not accept it than, I will be notified and will

be required to reclaim my property within 30 days of contact. Donor is responsible for retrieval of

item(s) and failure to reclaim property within the specified time gives the MCHC the right to dispose

of the property at its digression.

Received by:____________________

Received from: ____________________

(Staff/museum representative signature)

(Donor signature)

Date: __________________________

Date: ____________________________

S:\Forms\Temp custody form to print.docx

Temporary Custody Receipt Form - Monroe County History Center Page 2