Autry National Center

The Regents of the University of California on behalf of its UCLA Library TEMPORARY CUSTODY RECEIPT

for one of the following UCLA Libraries

 Arts  Geology  Sciences and Engineering  Biomedical  East Asian  Special Collections

 Chemistry  Management  Charles E. Young Research Library  College  Music The objects identified below are received subject to the terms and conditions printed on the reverse side.

Received from: ______Name of Legal Owner (Person, Foundation, Trust, etc.)

______Name of Authorized Representative ______Address ______City/State/Zip Code Phone email

Date of issuance of receipt: ______

Purpose of Custody: Gift x Other (Specify)______

Description of Object(s) Condition

(see conditions on next page) UCLA Library-Print Acquisitions Department- Gifts & Exchanges, 11020 Kinross Building South, Los Angeles, CA 90095-7230- Ph(310) 794- 4019 Fax (310)206-4974- email: [email protected]

Temporary Custody Receipt - September 2010

Location of Objects(s) during custody: UCLA Library

______Signature of Date

______Signature of Date Signature of Date x Legal Owner(s) UCLA Library Staff x Owner’s Authorized Representative

Conditions:

1. This receipt does not constitute formal acceptance of the object(s). It is understood that any of the listed items which are accepted as a donation to the The Regents on behalf of its UCLA Library will be listed on a separate Deed of Gift form which will be sent to the address indicated on this receipt. If The Regents decides not to accept the object(s) as a donation, Owner has 30 days from notice of non- acceptance to claim such object(s). Any object(s) not claimed within the 30 day period shall become the unrestricted property of The Regents.

2. The donation process will be completed when the Deed of Gift form is completed, signed and returned to UCLA Library Gifts & Exchanges, thereby transferring said property as a gift to The Regents of the University of California for the benefit of its Los Angeles Campus on the terms and conditions expressed in the Deed of Gift.

3. If the donation process is not completed within 90 days after the date of Temporary Custody Receipt (TCR), all object(s) shall be deemed an unrestricted gift to the The Regents on behalf of the UCLA Library and shall become the unrestricted property of The Regents.

4. Final disposition of the object(s) shall be determined by the UCLA Library. The Regents has the right to dispose of the object(s) as it deems appropriate.

5. Unless the UCLA Library is notified to the contrary in writing the object(s) received may be photographed and reproduced for its private purposes. It is understood that the UCLA Library will not clean, restore, or otherwise alter the object(s) without the written consent of the Owner.

6. If the legal address or contact information of the Owner shall change during the pendency of this temporary custody, the responsibility rests with the Owner to notify the UCLA Library of any such changes.

7. In the event the object(s) are offered for donation to The Regents, Owner warrants that he/she is prepared to establish that full clear title to the objects can be passed to The Regents.

8. Attribution, dates, descriptions, valuations and other information about the object(s) on this Receipt are given by the Owner. Any valuations are not to be considered as appraisals by The Regents. UCLA Library-Print Acquisitions Department- Gifts & Exchanges, 11020 Kinross Building South, Los Angeles, CA 90095-7230- Ph(310) 794- 4019 Fax (310)206-4974- email: [email protected] -- Temporary Custody Receipt - September 2010

9. This Receipt shall be governed by the laws of the State of California.

10. Original copy of Temporary Custody Receipt will accompany the donated materials to Gifts & Exchanges and a copy will be given to the Owner to complete the transaction.

For Office Use Only:

. TCR issued: ______x Gift Services: ______

. DoG +SoV sent: ______. Acknowledgement sent: ______

. DoG+SoV receieved: ______. Paperwork PDF’ed: ______

. Paperwork filed: x Print Acq: ______. AT data entered: ______

UCLA Library-Print Acquisitions Department- Gifts & Exchanges, 11020 Kinross Building South, Los Angeles, CA 90095-7230- Ph(310) 794- 4019 Fax (310)206-4974- email: [email protected] -- Temporary Custody Receipt - September 2010