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LOAN FORM THE MINNEAPOLIS INSTITUTE OF ARTS 201 East 24th Street, Minnesota 55404 Telephone (612)339-7661, Cable: Minnari From: Byron Gallery 1018 Madison Avenue New York, N.Y. 10021 Return Address (If different from left.) Purpose: Exhibition Dates: October 17-November 24, 1968 To be insured By: [[X]] Borrower; [ ] Lender. (if Lender, please supply waiver of subrogation against The Minneapolis Institute of Arts.) Are photographs available: [ ] Yes; [X] No. Shipment Via: [ ] REA [ ] Air Express [ ] Other______ To arrive no later than: To be shipped on or about: Credit line if different from above: Byron Gallery Re: Sam Gilliam The Loans Listed Hereunder are made Subject to the Conditions on the Reverse Side. [6 columns] | Lender's Number | Artist | Exact Title & Date | Medium & Support | Dimensions Height 1st | Insurance Value | |---|---|---|---|---|---| |---| Sam Gilliam | Shift Again | Acrylics | 104x45" | $ 1,700.00 | Lender may retain the white copy. Please return all others to: The Director, The Minneapolis Institute of Arts, 201 East 24th Street, Minneapolis, Minnesota 55104. ________________________ Lender's Signature _____________ Title _____________ Date