Repository Receipt For Collections - Bureau Of Land Management
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1
2Bureau of Land Management
Submit to the appropriate State Office
BLM Verification of Collections
(completed by BLM)
BLM Official:
Date Received:
REPOSITORY RECEIPT FOR COLLECTIONS
Artifacts and specimens recovered from BLM-administered lands are Federal property, and must be managed in a manner consistent with Federal
stewardship responsibilities for museum collections. Cultural or paleontological resource permits for collecting activities require that the permittee
arrange for curation of artifacts and specimens in an appropriate repository. Collections must be deposited in a repository for curation within one year of
completion of the permitted project, unless alternate arrangements have been approved by the BLM permitting official.
This Deposition of Museum Collections Confirmation and Inventory form is required as a condition of the permit and must be completed for all museum
collections originating from BLM administered lands, with the associated documentation, to ensure collections are deposited in an appropriate curatorial
facility. A receiving document generated by the repository may be substituted if it contains the same information as this form.
Instructions
1.
All information requested on this form must be completed by the permittee and repository officials.
2.
Permittees must provide an itemized inventory of the objects, lots, samples, and associated documentation to be deposited attached to this
statement. The inventory must include site or locality designation, number of units per material type according to BLM and the
repository standards. A complete collection includes:
•
All artifacts, specimens, and environmental materials collected with provenience data
•
All survey or excavation records and logs
•
All maps showing locations and boundaries
•
All valid photographs, negatives, and slides
•
All analysis records, and copies of all reports and publications
3.
A repository official must acknowledge receipt of the collection. Before signing, the repository official should compare the inventory to
the actual objects and records being deposited.
4.
If the permittee and the Repository Official are the same individual, an additional Repository Official must be signatory to this form.
5.
After this form has been signed by the repository official, the original form with the collection inventory must be submitted the BLM
State Archaeologist by the permittee.
6.
Upon submission to BLM, the BLM official may contact the repository to verify the inventory of collections deposited by the permittee.
Permittee Information
Permit Number:
Permittee Name:
Address:
City, State Zip Code:
Telephone Number:
Certification of Collection Deposition in Repository by Permittee
I,_________________________(Permittee) certify that __________________________(name of repository) has on this date, _____________,
accepted the collections of objects, lots, samples, and associated documentation described on the attached inventory.
Signature:
Date:
Complete or Partial Deposit (check one)
I certify that the inventory represents all materials and associated documentation from the work performed under this permit (complete
deposit).
I certify that this represents a portion of the materials and associated documentation. The attached sheet lists what materials are not yet
deposited, the reason they are not deposited at this time and when they are expected to be deposited (partial deposit).
Curation Facility Information
Repository Name:
Address:
City, State Zip Code:
Telephone Number:
Official Authorizing Receipt (name and title):
Accession Number Assigned by the Repository:
Receipt of Collection Statement by Repository Official
I, ___________________________ (Repository Official) certify that the ________________________________(name of facility) has on this
date,____________, accepted the collections of objects, lots, samples, and associated documentation described on the attached inventory from
________________(permittee).
Signature:
Date:
Attachment 2-1
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