Telephone & fax number, if available:
Artist:
Title/Date:
Medium:
Dimensions of raw work: Height: Width: Depth:
Dimensions with frame (if applicable): Height: Width: Depth:
Does the work have a crate?
Estimated value:
Can you provide a reproduction of the work (in any format)?
When will the work be available for intake?
Address for collection of donated work:
- Contact name I
(if different from Donator): - Telephone number:
- Fax number:
- Contact name II
(if different from Donator): - Telephone number:
- Fax number:
CONDITIONS
The work of art referred to in this donation agreement (the “Work”) becomes property of the New York Psychoanalytic Society following its donation. You acknowledge that the Work will be displayed for public viewing as well as put up for sale at auction, and that upon donation, the Donator forfeits all ownership and control over the Work to the New York Psychoanalytic Society. The New York Psychoanalytic Society may also make reproductions of the Work both for use in a publicity context as well as to sell to the public.
The New York Psychoanalytic Society will exercise the utmost care in respect to handling the Work and its safekeeping, as it does in safeguarding its own property of the same or similar nature. However, the New York Psychoanalytic Society assumes no guarantee of protection for any Works held in its possession following the donation.
The loan of this Work constitutes a donation to the New York Psychoanalytic Society, who will use the profits generated from its sale to benefit the New York Psychoanalytic Society.
One-half (50%) of any profits generated from sales of reproductions of the Work will be given to the Donator. The remaining one-half (50%) will be used to benefit the New York Psychoanalytic Society.
I agree to donate, at no cost, the above-indicated Work to the New York Psychoanalytic Society with the knowledge that it is intended for sale at auction and have read and agree to the above conditions governing this donation.
Signature of Lender
Date
