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Atlanta

EXHIBITION LOAN FORM
RUDER & FINN INCORPORATED
130 EAST 59TH STREET NEW YORK, N.Y. 10022

Exhibition Dates: 12/1/68-12/31/69 
Name of Lender: Byron Gallery, 1018 Madison Ave., New York 
Artist's Name: Sam Gilliam 
Title of Work: "Shift Again" Year: 1968 
Dimensions (Height first): 104" x 45" 
Medium: Acrylics|
Insurance Valuation: $1,700.00 

______________________
Lender's Signature:
_____________________
Title:  
________________
Date:  

Ruder & Finn Incorporated will insure the work at the value listed above, covering it not only during the exhibition period, but during transit to and from the gallery.

Nina Kaiden/Caroline Lerner
Ruder & Finn, Inc.
130 East 59th Street
New York, N.Y. 10022
212- Plaza 9-1800

---Please return two copies and retain one for your files ---