DEED OF GIFT

Lawrence County Historical & Genealogical Society

Bedford, IN

A Not-For-Profit Organization

Donor’s Name:_______________________________________________________

Address____________________________________________________________

City__________________________ State___________ Zip Code____________

Phone Number________________________ Date Donated___________________

Donor’s Appraisal of Market Value______________________________________

ITEMS DONATED:

1) ________________________________________________________________

2) ________________________________________________________________

3) ________________________________________________________________

4) ________________________________________________________________

5) ________________________________________________________________

I (we), being the sole legal owner(s) of the property described above, hereby give the Lawrence

County Museum of History, for its use and benefit without restriction as to use or disposition, the

property described above. In addition, I (we) give all copyright and associated rights I (we)

have. To the best of my (our) knowledge I (we) have good and complete right, title, and interest

(including all transferred copyright, trademark, and related interests) to give. I (we) have no

objections to my (our) name(s) appearing as donor(s) in connection with this gift in Museum

records, publications, and other descriptions. No goods or services were received in exchange

for this donation.

____________________________________________ Date ______________________

Donor’s Signature

____________________________________________ Date ______________________

Authorized Society Member’s Signature

This gift is given in memory of: _____________________________________________

Donor’s Copy________ Society’s Copy________

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