Object Information Form

Please tell us about the person most associated with this object (the maker/artist, original owner etc.)
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Place of Birth*
Year of Birth*
Place of Death*
Year of Death:*
Place of residence:*
Occupation*
Place of Business and dates:*
This person's community involvement (memberships in organizations (church, etc.) or other positions or activities in York County, Pennsylvania:*

How did you obtain this object?
Choose 1 option*
Please give us details as it relates to your answer above - Where?, When? From whom? *
Previous owners, users and dates, if known?
If you know of any other owners or users of this object, please list them.*
Do you have an image of the owner, user, maker, or object that we may reproduce?*

YesNo
Maker:*
Location made?*
Date Made*
Makers background:*
How was the object used?*
Location of use:*
Dates of use:*
Describe how it worked or any unusual features:*
Does anyone else have information about the object or its owner or maker?*
Have you spoken to a York County History Center staff member? If so, who?*
Do you have any reference material (manuals, photographs, newspaper articles) about the object that we may reproduce?*

YesNo
If necessary, please tell us more information you may have, such as useful diagrams, family genealogy w/names, family stories, anecdotes, etc.*

I HAVE LEGAL TITLE TO THE ABOVE OBJECTS*

YESNO
I INTEND TO DONATE THE ABOVE OBJECT(S) TO THE YORK COUNTY HISTORY CENTER PENDING THE APPROVAL OF THE COLLECTIONS COMMITTEE.*

YESNO
Owner's Signature*

Clear
Today's Date*

MonthDayYear
Date
You may upload up to six image files. Maximum size per each image is 10MB. We can except the following file types: .pdf, jpg, jpeg, png, gif.

Browse Files

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OBJECT INFORMATION FORM