Viewing page 12 of 95

This transcription has been completed. Contact us with corrections.

[[image - logo]]
LOAN AGREEMENT

THE GALLERY OF MODERN ART INCLUDING THE HUNTINGTON HARTFORD COLLECTION COLUMBUS CIRCLE NEW YORK 10019

Request for Loan from: Byron Gallery, 1018 Madison Avenue, New York, New York

Exhibition: Dealers' Choice
To arrive no later than December 5, 67
To be returned      
Return address: same as above
Shipment via: we will contact you
To be insured by: Lender [ ]   Borrower [X]
Credit line if different from above:

Are photographs available?
Please send one and bill The Foundation for Modern Art, Inc.
Is a photoengraving available?
Black and white size
Color size

[[6 Columned Table]]
| Museum No. | Artist | Exact Title & Date | Medium & Support | Dimensions Height 1st | Insurance Valuation
|---|---|---|---|---|---|
|   | Sam Gilliam | SHIP | Acrylics on Canvas | 91x42 | $1200- |

return one copy to:
THE REGISTRAR
GALLERY OF MODERN ART
2 Columbus Circle, N.Y. 19, N.Y.

Lender's Signature
Title
Date
Telephone: 212-LT-1-2311
Please See Reverse Side

The Foundation for Modern Art, Inc.