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Please RETURN TO:
[[preprinted]] THE AMERICAN FEDERATION OF ARTS
National Headquarters: [[strikethrough]]Barr Building[[/strikethrough]], Washington 6, D. C.
^[[1262 New Hampshire Avenue, N. W.]]

FOUNDED [[logo with A [[dot]] F [[dot]] A within map of the US with the words THE AMERICAN FEDERATION OF ARTS above and FOR THE ADVANCEMENT OF ART IN AMERICA below the map]]IN 1909
[[/preprinted]]
[[underlined]]Loan Authorization Form No[[/underlined]]. 65
April  , 1949

TO: Corcoran Gallery of Art

FROM: Jacques Seligmann Galleries, 5 East 57th Street, New York City

This is to authorize the inclusion of the work listed below in the AFA Traveling Exhibition of "THE 1949 CORCORAN BIENNIAL" following the close of the Washington, D. C. showing on May 8th.

The Corcoran Gallery is hereby released of all responsibility for the custody of the work upon its delivery to the Federation for tour.
[[4 column table]]
[[underlined]] TITLE OF WORK AND MEDIUM | NAME OF ARTIST | SALES PRICE | INSURANCE VALUATION [[/underlined]]
"London Ruins, Spiral Staircase" | Cleve Gray | ^[[500.]] | ^[[400-]]
[[/4 column table]]

Signed: .................. Kindly sign and complete duplicate form.
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