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California State University, Long Beach     
Art Gallery: 213 498-4367 
6101 East Seventh Street
Long Beach, California 90840  LOAN AGREEMENT
Exhibition: Roy Lichtenstein: Ceramic Sculpture
Dates Of Exhibition: February 22- March 21, 1977
Lender:
Address: 
Return shipment will be made to this address unless otherwise instructed.
Credit :
Lender's name as it should appear in the catalogue and on gallery label.
Artist:
Title: Head With Blue Shadow     Date:
Medium:________Dimesions in inches:   H.   W.  D.
Painting, drawing, print: without frame of mat. Sculture: without base. Full size including frame or base: H. W. D.  .
Date:        Signature:   How Signed      Where
Condition:   
Insurance: Valuation:
Coverage: Unless otherwise specified, California State University, Long Beach will insure in the amount specified above throughout the period of loan.

Sale:  If work is for sale, note price: $     (See conditions)
Framing: Is the work framed?   . May we encase the entire work in a plexiglass container?   . If necessary for the exhibition, may we reframe or remat your work?    .May we substitute plexiglass for glass?   . (All works will be returned to the lenders in their original frame and mat unless other arrangements are made with the University in writing.)

TRANSPORTATION: To arrive in Long Beach no later than February 1, 1977
Shipping instructions will follow

PHOTOGRAPHS: Are photographs available? Yes:  No:  . If available, please send  8x10 glossies. Permission to reproduce in the catalogue, for publicity and for educational purposes, is assumed unless otherwise stated by lender. Is color reproduction material available? Yes:  No:  . If yes, please state type: (plates), (color separations), (transparencies). 
May this work be photographed for television broadcast in connection with the exhibition: Yes: No:  .
CATALOGUE: Previous collections, exhibitions, publications, bibliography. (Please indicate on separate sheet.)
CONDITIONS GOVERNING LOAN: THIS LOAN IS SUBJECT TO THE CONDITIONS PRINTED ON THE REVERSE OF THIS FORM.
Signature of Legal Owner:  Date:
or Authorized Agent:       Date:
PLEASE RETURN THE ORIGINAL, KEEPING THE COPY FOR YOUR RECORDS. WHEN YOUR LOAN IS RETURNED TO YOU, PLEASE SO INDICATE BY SIGNATURE 
DATE    ON YOUR COPY AND RETURN TO CSULB ART GALLERIES.