Dissolution of Public and Association Libraries in New York State
S A M P L E
RECEIPT FOR TRANSFERRED LIBRARY PROPERTY
This document in MS Word format |
[55K] The University of the State of New York
The State Education Department
New York State Library / Division of Library Development
10B41 Cultural Education Center
Albany, NY 12230
We, the trustees of _______________________________ , have received from the board of trustees of _____________________ the books and other
library property described in the following inventory and transferred by them to us by vote of __________dated _________ 20___ for the free use of the inhabitants of (specify locality to be served) _____________________________.
Having received the approval of the Regents under seal we give this receipt in accordance with Education Law, by which the entire responsibility for the said property is transferred and hereby accepted. Signature Board President: ____________________________________
Sign two copies (Board President) send one to The New York State Library, Division of Library Development, Cultural Education Center, Room 10B41, Albany, NY 12230. Attach the other to the Regents' approval and file with the board making the transfer as evidence of full relief from further responsibility for the project.
LIBRARY ASSETS
| Library Collection | Number of Items |
Estimated Value |
| 1) Print Materials | $ | |
| 2) Electronic Materials | $ | |
| 3) All other non-book - physical items | $ | |
| 4) TOTAL Library Collection (add lines 1-3) | $ |
| Other Property & Assets | Estimated Value | |
| 5) Building and Grounds (indicate one) | ||
| Own | Rent | $ | |
| 6) Library furniture and equipment | $ | |
| 7) All other assets not included in #5 and #6 above (real estate, investments, stocks, bonds, mortgages, etc.) | $ | |
| 8) Accounts receivable total | $ | |
| 9) TOTAL Other Property & Assets (add lines 5-8) | ||
| Cash on hand and in bank including Capital Fund | ||
| 10) Cash | $ | |
| 11) Capital Fund | $ | |
| 12) TOTAL Cash on hand and in bank and Capital Fund (add lines 10-11) | $ | |
| GRAND TOTAL (add lines 4, 9, and 12) | ||
(Signature of trustees)
STATE OF NEW YORK )
ss:
COUNTY OF )
On this __________ day of __________, 20___ before me personally came the ____ (insert number of trustees whose signatures appear above), to me known to be the persons described in and who executed the foregoing application, and severally duly acknowledged to me that they executed the same.
(Typed name, stamp and signature of notary public)