DCHS Temporary Custody Receipt

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Name

Email

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

The items listed below are left in the custody of the The Dutchess County Historical Society to be considered as (choose one):

An unconditional donation. The Museum reserves the right to keep, lend, or otherwise dispose of the donated material.
To be considered for acquisition.
To be considered for acquisition.
For identification. Does not constitute an authentication; will not include appraisals. Museum reserves the right to photograph.
For other please specify in space below:

Disposition if not accepted for accession (choose one):

Item(s) description

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