CERTIFICATE OF GIFT
being the owner,
hereby gives, delivers, and transfers to LSUS Archives and
Special Collections the following item(s), to wit:
to be used by said Archives as a part of its historical collections for exhibition and for
research and reference by historians, students, faculty, and the scholarly public. Said
archives is granted all rights and title thereto, including copyright and literary rights,
which owner may have or may be deemed to have, and shall have the right to determine what
use and disposition shall be made of said item(s), subject to the following stipulations
described materials shall be permanently established and known as
____________________________________________ and shall be administered in accordance
with the policies and practices of LSUS Archives and Special Collections.
LSUS Archives and Special Collections agrees to house, preserve, and exercise reasonable
care in the use and storage of the said item(s).
Dated at __________________________, this ____ day of __________________, 20___.
Signature of donor
Signature of LSUS Representative