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[[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.