THE HSWAGATA BUDDHA TOOTH RELIC PRESERVATION MUSEUM
FOR INTERNAL USE ONLY
Template No.: T178
Template Title: Donation Acceptance & Use Form (In-Kind / Relics / Objects)
Related Research Case IDs / Cluster: Cluster D (Everyday Faith & Lay Donations), Cases 36–45 (also link E/F/G if verification, dispute, or loss risk applies)
Linked Templates / Policies: T176 (Lay Donor Registration), Donation Handling Policy, Collections/Accession Policy, Relic Safeguarding Policy, T173 (Records Classification), T163 (Risk Register Entry), Scientific Verification SOP (if used), Conflict Resolution/Security SOP (if used)
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 [ ]
1) Purpose (why we use this form)
This form records and checks non-cash gifts (objects, materials, or relic-related items).
It helps accept gifts safely, ethically, and with a clear storage plan.
2) Donor details (link to T176 if possible)
Donor name (preferred): _______________________________________
Donor ID / link to T176 (if any): ______________________________
Contact (phone/email) (optional): _______________________________
Donation date received: ____ / ____ / ______
Received at (place): __________________________________________
Received by (name/role): ______________________________________
Was the donor a group? Yes [ ] No [ ]
If Yes, group name: _____________________________________________
3) Item type (tick one)
Relic / relic fragment (Sacred-Restricted) [ ]
Relic container / reliquary [ ]
Stupa item / ritual object [ ]
Manuscript / document [ ]
Photo / artwork [ ]
Museum equipment / supplies [ ]
Other object: __________________________ [ ]
Sensitivity note: If this is a relic or includes relic security details, mark Sacred-Restricted.
4) Item description (what is offered)
Item name / short title: ____________________________________________
Quantity: ________
Materials (if known): ______________________________________________
Size/weight (if known): ____________________________________________
Marks/inscriptions (if any): ________________________________________
Photos taken? Yes [ ] No [ ]
Photo file location/path: ___________________________________________
Donor’s stated purpose (why they give it):
5) Condition check (basic)
Condition at receipt (tick):
Excellent [ ] Good [ ] Fair [ ] Poor [ ] Unknown [ ]
Visible issues (tick all that apply):
Cracks [ ] Chips [ ] Dust/soil [ ] Mold [ ] Water damage [ ] Rust [ ] Insects [ ] Bad smell [ ] Other: ______
Short condition notes:
Immediate risk to people or other collections (mold/insects/chemicals)?
Yes [ ] No [ ]
If Yes, isolate item and inform Conservation. Action taken: _____________
6) Origin / provenance (where it comes from)
Donor statement (write clearly, simple words):
Where did the item come from? ____________________________________
How did the donor get it? (gift, inherited, bought, found, temple transfer):
Approx. date acquired (if known): ____ / ____ / ______
Any previous owner(s) (if known): __________________________________
Documents provided (tick):
Letter from donor [ ] Receipt/proof of purchase [ ] Temple letter [ ] Old photos [ ] Permit [ ] None [ ] Other: ______
Provenance risk flag (tick if any concern):
No concern [ ] Some concern [ ] High concern [ ]
Reason (facts only): ________________________________________________
7) Legal and ethical check (must complete)
Tick Yes/No/Unknown.
Donor says they have the right to donate this item.
Yes [ ] No [ ] Unknown [ ]Item is not stolen, not looted, and not taken from a protected site.
Yes [ ] No [ ] Unknown [ ]If cross-border, any needed permits/customs papers exist.
Yes [ ] No [ ] Unknown [ ] NA [ ]Accepting this item will not cause community conflict or harm.
Yes [ ] No [ ] Unknown [ ]No pressure or payment was involved in receiving this gift.
Yes [ ] No [ ] Unknown [ ]
If “No” or “Unknown” on any key point, what is the plan?
Hold for review [ ] Ask for more documents [ ] Decline/return [ ] Report/consult authority [ ]
Notes: ____________________________________________________________
8) Verification and handling plan (if needed)
Is verification needed? Yes [ ] No [ ]
If Yes, reason (tick): Authenticity question [ ] Material safety [ ] Historical record [ ] Public claim risk [ ] Other: ____
Planned steps (tick):
Visual exam by Conservation [ ]
Photography/documentation [ ]
Non-destructive testing (if allowed) [ ]
Consult scholar/monastic advisor [ ]
Consult partner lab/university [ ]
Other: __________________________ [ ]
Restrictions: No destructive sampling without top approval. Yes [ ] No [ ]
Approving authority if ever needed: Board [ ] Director [ ] Abbot/Sangha authority [ ]
9) Acceptance decision (what we decided today)
Decision (tick one):
Accept now [ ]
Accept with conditions (pending checks) [ ]
Do not accept (decline) [ ]
Return to donor [ ]
Hold temporarily (no accession yet) [ ]
Conditions (if any):
Reason for decline/return (if used):
10) Storage plan (where it will go)
Immediate storage location (today): _______________________________
Long-term storage plan (after checks): ____________________________
Handling level (tick):
Normal museum object [ ] Restricted [ ] Sacred-Restricted [ ]
Access allowed for (roles only): ______________________________________
Environmental needs (if any):
Cool/dry [ ] Low light [ ] Sealed box [ ] Pest control [ ] Other: ______
Security needs (if any):
Locked cabinet [ ] Two-person access [ ] Access log [ ] Escort required [ ] Other: ______
11) Registration / accession (museum record)
Temporary intake number (if used): _______________________________
Accession number assigned? Yes [ ] No [ ]
If Yes, accession number: __________________________________________
Catalog entry completed? Yes [ ] No [ ]
Completed by (name/role): _______________________ Date: //____
Classification recommended (T173):
Public [ ] Internal [ ] Restricted [ ] Sacred-Restricted [ ]
Retention (for intake file): 3 years [ ] 5 years [ ] 10 years [ ] Permanent [ ] Other: ____
12) Use plan (how the gift may be used)
Tick and note.
Display (public) [ ] Conditions/limits: ____________________________
Display (special/restricted) [ ] Conditions: _________________________
Storage only (no display) [ ] Reason: ______________________________
Education (non-sensitive) [ ] Notes: _______________________________
Research (approved) [ ] Notes: ____________________________________
Conservation treatment needed [ ] Notes: ___________________________
13) Thanks and acknowledgment
Official receipt/acknowledgment letter issued? Yes [ ] No [ ]
Receipt/letter number: __________________________ Date: //____
Thank-you sent? Yes [ ] No [ ]
Method: SMS [ ] Email [ ] Letter [ ] In-person [ ] Other: ____
Date sent: ____ / ____ / ______ Sent by (name/role): __________________
Public acknowledgment allowed by donor? Yes [ ] No [ ]
If Yes, how: name list [ ] plaque [ ] annual report [ ] other: ______
14) Signatures and approvals
Received by (name/role): _______________________ Signature: __________ Date: //____
Conservation check (name/role): ________________ Signature: __________ Date: //____
Security review (if restricted): ________________ Signature: __________ Date: //____
Approved by (Director/Authority): ______________ Signature: __________ Date: //____
15) Attachments and filing
Attachments (tick):
Donor letter [ ] Photos [ ] Provenance documents [ ] Permit copies [ ] Condition notes [ ] Verification notes [ ] Other: ______ [ ]
File code / reference ID: ____________________
File location (cabinet/folder + digital path): __________________________
