DEED OF GIFT --Please print:

Name: ______________________________ Address: _______________________________
City: ______________________________ State: _________________________________
Telephone: ( )____________________ Zip Code: ______________________________I, ___________________________________, hereafter referred to as the “Owner,” attest or affirm that I have legal authority to donate the property described below and irrevocably hereby give, transfer, assign, and deliver all of the Owner’s right, title, and interest in and to the property described below, including all copyrights, both common law and statutory, which the Owner may possess in said property as a gift to THE JUNE L. MAZER LESBIAN ARCHIVES. Dated this ______ day of _____________________. Signed: __________________________
Owner
Description of property (circle all that apply):
Art Work Clipping Journal Phonograph Record
Audiotape Comic Book Magazine Photograph
Blueprint Compact Disk Manuscript Photographic Slide
Book Correspondence Map Plan
Brochure Diary Matchbook Poster
Bumper Sticker Dissertation/Thesis Microfiche Printout, Computer
Button Film Microform Report
Calendar Financial Record Minutes Scrapbook
Card Flyer Mug/Cup T-shirt
Chart Form Newspaper Videotape
Other: ______________________________________________________________
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Any items not retained are to be returned to owner: yes _____ no _____
If no, may be disposed of at the discretion of the Mazer Archives.
Materials may be published on the Internet: yes _____ no _____
Are any materials to be sealed? yes _____ no _____
If yes, specify which materials and the date they may be available to the public:
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____________________________________________Other restrictions:

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___________________________________________May we publish the donor’s name in our newsletter and, if you arenot the donor (e.g., you are the executrix of an estate), may we publish your name? Yes _____ no _____Tell us anything else you would like us to know about your donation (e.g., its special herstory and/or personal significance, specific circumstances under which you acquired it, etc.). Feel free to attach additional sheets:
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________________________________THE JUNE L. MAZER LESBIAN ARCHIVES hereby accepts the above property under the specified restrictions above. This DEED OF GIFT represents all of the conditions and restrictions placed on the gift.