Required fields are marked with asterisks (*)

Digital Loan Returned Form

Loan Information

Loan ID

Date of loan return

Loaned Item Details

Item Number

Brief Description

Returner Information

Name of Loaner or Inheritor

Relationship to Original Loaner (If applicable)

Address

Email Address

Phone Number

Confirmation of Authorization:

· As the Loaner or Descendant of the Loaner, I am authorized to take possession of the personal property described above previously loaned to the Municipality of Northern Bruce Peninsula and the St. Edmunds Bruce Peninsula Museum.

Signature of Loaner or Inheritor

Clear

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