OUTGOING RELIC LOAN AGREEMENT FORM Form Code: HSW-F11

 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: ____/____/____