APPRAISAL FORM

Waiver / Disclaimer: I understand and agree fully to the following: This is an informal appraisal, based upon the appraiser's assumption that the information I have provided is accurate. The appraisal shall be formulated by the appraiser's professional and discretionary estimation of the quality, condition, and market desirabiltiy of the artwork submitted, combined with the average price at public auction for a similar work. The appraisal figure may be lower or higher than my painting's actual market value. This appraisal is for unofficial and preliminary valuation only, and will not be used for purposes of estate/asset liquidation, insurance, auditing, or taxation. Should I attempt to use this appraisal for such purposes, such usage will be at my own risk, and I hereby indemnify and release the Kelley Gallery from any and all liabiltiy connected to same.

If you are in possession of a19th/20th century painting and would like to have it appraised, please fill in the form below as fully as possible. Sorry, but we do not evaluate prints.

CONTACT DETAILS

(All fields must be completed unless indicated otherwise).

Name:

Email Address:

Street Address:

City:

State / County:

Country:

Zip / Postal Code:

Telephone:

Fax:

Preferred method of contact:

PICTURE DETAILS

Email:

Post:

Fax:

Phone:

Description: Please describe your picture giving as much detail as possible. Medium: e.g. oil, waterpainting, pastel, drawing, photograph, etc.

Dimensions: measure your picture in inches or centimeters, height before width; excluding its frame (if applicable).

Inches:

Centimeters:

Signature: Please describe, sketch, or send photographs of any signatures or monograms.

Condition: Please detail accurately any damage or wear. Although repairs are often difficult to detect, try to describe any flaw or other evidence of restoration. For example: rips, holes, stains.

Provenance: Please describe the source of your object, especially with regard to its original ownership and/or recent history. Did you, for instance, buy it from an antique dealer or inherit it from your family?

Exhibition History: Has your picture ever been exhibited or appeared in any publications?

Yes:

No:

Don't Know:

If so, please list:

Additional comments: Please also include any other comments or information that you believe might help us to help you.

Photograph:For best appraisal results: Please send crisp, clear photographs of your painting (taken outdoors to avoid flashback/glare), along with the info you have provided on this form, to the address below or please send as an email attachment to Appraisals@MKelleyArt.com

Please be aware that in certain cases we may be unable to be of assistance.

Contact:

Kelley Gallery

1000 E Walnut Ave. Suite 125,

Pasadena, Ca. 91105

(001) - 626 - 577 - 5657