THE HSWAGATA BUDDHA TOOTH RELIC PRESERVATION MUSEUM
FOR INTERNAL USE ONLY
Template No.: T-TK016
Template Title: Chain-of-Custody Form Set (Movement Gap During Transfer)
Related Research Case IDs / Cluster: TK-016 / Cluster E (Testing & Evidence) + Cluster G (Neglect & Loss Prevention)
Linked Templates / Policies: Access Control Policy; Key/Card Management SOP; T-TK015 Testing Request SOP; T-TK013 Exit & Handover Protocol; Incident Reporting Form; Data Protection & Confidentiality Policy; Sacred-Restricted / Sensitive Handling Rules; Publication Approval Workflow (T-TK006)
Date of form: ____ / ____ / ______
Prepared by / Role: _______________________
Office / Unit: ____________________________
Country / Location: _______________________
Confidentiality Level:
Internal only [ ] Restricted [ ] Sacred-Restricted / Sensitive [ ]
Use of this form (tick):
New case / action [ ] Follow-up [ ] Annual review [ ] Archive only [ ]
Chain-of-Custody Form Set (use all that apply)
Core rule: No movement without written authorization + signed handovers.
Two-person rule: At least 2 HSWAGATA staff must witness every handover for relic items.
FORM A — Movement Authorization (must be approved before moving)
Movement Request ID: TK016-A-__________
Date/time requested: ____ / ____ / ______ _______
Requested by (name/role): ______________________________
Item(s) to move (list all):
Item ID / Name: ____________________________ Qty: ____
Item ID / Name: ____________________________ Qty: ____
Purpose (tick):
Testing [ ] Conservation [ ] Display [ ] Storage change [ ] Loan/return [ ] Emergency [ ] Other: ______
From (location): ____________________________
To (location): ______________________________
Planned depart: ____ / ____ / ______ _______
Planned return (if any): ____ / ____ / ______ _______
Escort team (2-person minimum):
Escort 1: __________________ Role: __________
Escort 2: __________________ Role: __________
Security support needed? Yes [ ] No [ ]
Approval (required):
Collections/Relic Officer: ________________ Sign: ______ Date: //______
Security/Duty Manager: ___________________ Sign: ______ Date: //______
Board delegate (for High/Critical): ________ Sign: ______ Date: //______
FORM B — Item Condition Check (Before Movement)
Condition Form ID: TK016-B-__________
Date/time: ____ / ____ / ______ _______
Checked by: ____________________ Second witness: ____________________
Item ID: ____________________________
Container ID (if any): _______________________
Condition (tick):
Good [ ] Fair [ ] Poor [ ] Unknown [ ]
Notes (simple, no long story):
Photos taken (follow sacred rules): Yes [ ] No [ ]
If yes, file name(s): ______________________________________
FORM C — Packing & Seal Record
Packing Form ID: TK016-C-__________
Date/time packed: ____ / ____ / ______ _______
Packed by: ____________________ Second witness: ____________________
Item ID(s): _______________________________________________
Packing method (tick):
Original container [ ] Double container [ ] Padded box [ ] Hard case [ ] Other: ______
Seal used? Yes [ ] No [ ]
If yes: Seal number(s): ___________________________________
Seal placed by: __________________ Witness: _______________
Label on case (write code only, no public words):
FORM D — Custody Transfer Log (main chain-of-custody log)
Custody Log ID: TK016-D-__________
Rule: Every handover must be signed. No blank lines.
| Step No. | Date | Time | From (Name/Role/Org) | To (Name/Role/Org) | Location | Reason (short) | Seal no. checked? (Y/N) | Item count checked? (Y/N) | Sign From | Sign To | Witness 1 | Witness 2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | ||||||||||||
| 2 | ||||||||||||
| 3 | ||||||||||||
| 4 |
If a step is missed: stop movement and open FORM G (Gap/Incident Addendum).
FORM E — Transport Checklist (during travel)
Transport Form ID: TK016-E-__________
Date: ____ / ____ / ______
Vehicle/Transport type: Museum vehicle [ ] Secure courier [ ] Police escort [ ] Other: ______
Escort 1: ____________________ Escort 2: ____________________
Tick each item:
Case kept in sight at all times [ ]
No unscheduled stops [ ]
Case not left in vehicle alone [ ]
Temperature/heat risk controlled [ ]
Public photos not allowed [ ]
Route kept confidential (restricted) [ ]
Arrival time recorded [ ]
Unplanned stop? Yes [ ] No [ ]
If yes, explain (short): ____________________________________
FORM F — Receiving Check (At destination)
Receiving Form ID: TK016-F-__________
Destination: _______________________________
Date/time received: ____ / ____ / ______ _______
Received by (destination name/role): _________________________
HSWAGATA escorts present: __________________ / __________________
Two witnesses confirmed: Yes [ ] No [ ] (must be Yes)
Checks (tick):
Seal number matches Form C [ ]
Seal unbroken [ ]
Item count matches authorization [ ]
Case shows no damage [ ]
Storage place at destination is ready [ ]
Photos of seal taken (if allowed) [ ]
If seal broken or mismatch: STOP and use FORM G [ ]
Signatures:
Receiver (destination): ___________________ Sign: __________
Escort 1: ________________________________ Sign: __________
Escort 2: ________________________________ Sign: __________
FORM G — Gap / Incident Addendum (use when chain breaks)
Addendum ID: TK016-G-__________
Date/time issue found: ____ / ____ / ______ _______
Found by: ____________________ Second witness: ____________________
Type of gap (tick):
Missing signature/handover step [ ]
Time/location unclear [ ]
Seal mismatch [ ]
Item count mismatch [ ]
Case damage [ ]
Unplanned stop not recorded [ ]
Other: _______________________ [ ]
What happened (facts only, short):
Immediate actions taken (tick):
Movement stopped [ ]
Security/Duty Manager notified [ ]
Board delegate notified [ ]
Photos taken (restricted) [ ]
CCTV time noted (if available) [ ]
Incident Report opened [ ] Report ID: ______________________
Decision:
Continue movement with new handover record [ ]
Return item to secure storage [ ]
Hold item at destination (locked) until inquiry [ ]
Signed by: ____________________ (Duty/Security) Date: //______
Signed by: ____________________ (Collections) Date: //______
FORM H — Return & Close-Out (when item comes back)
Close-Out ID: TK016-H-__________
Date/time returned: ____ / ____ / ______ _______
Returned to (HSWAGATA location): ___________________________
Checks (tick):
Custody Log complete (Form D) [ ]
Seal checked and recorded [ ]
Condition checked after return (Form B) [ ]
Item stored in correct secure location [ ]
All files saved in secure folder [ ]
Final note (1–2 lines):
Filed by: _______________________ Date: ____ / ____ / ______
Reviewed by (Head/Security/Board delegate): ______________ Date: ____ / ____ / ______
