HSWAGATA BUDDHA TOOTH RELICS PRESERVATION MUSEUM
OUTGOING RELIC LOAN AGREEMENT FORM
Form Code: HSW-F11
Loan Reference Number: _______________________
Date: ____ / ____ / ______
1. RELIC DETAILS
1.1 Relic ID Code(s):
________________________________________
1.2 Relic Name(s):
________________________________________
1.3 Short Description:
________________________________________
2. BORROWING INSTITUTION / PERSON
2.1 Name of Institution / Person:
________________________________________
2.2 Address:
________________________________________
________________________________________
2.3 Contact Person:
Name: _________________________________
Phone / Email: ________________________
3. PURPOSE AND PERIOD OF LOAN
3.1 Purpose of Loan:
[ ] Exhibition
[ ] Research
[ ] Interfaith or cultural event
[ ] Other: ____________________________
3.2 Loan Period:
From: ____/____/____ To: ____/____/____
4. CONDITIONS OF LOAN
4.1 Insurance / Liability:
________________________________________
4.2 Display / Handling Conditions:
- Case type / security: _________________
- Lighting: _____________________________
- Environment (temperature, humidity):
______________________________________
4.3 Transport and Packing Arrangements:
________________________________________
4.4 Ritual / Respect Requirements:
________________________________________
5. SIGNATURES
For HSWAGATA Buddha Tooth Relics Preservation Museum:
Name: ______________________________________
Role: ______________________________________
Signature: __________________ Date: ____/____/____
For Borrowing Institution / Person:
Name: ______________________________________
Role: ______________________________________
Signature: __________________ Date: ____/____/____
6. RETURN CONFIRMATION (to be filled on return)
Relic returned on: ____/____/____
Condition on return:
[ ] Same [ ] Changed (details below)
Details:
____________________________________________
Checked By (HSWAGATA): _____________________
Signature: __________________ Date: ____/____/____
