Form 3E series January 2017

NATIONAL COMMISSION FOR CULTURE AND THE ARTS

SUBCOMMISSION ON CULTURAL HERITAGE
CULTURAL MAPPING PROGRAM
Mapping of Significant Tangible Movable Heritage
Category:Artwork

TITLE:
(refer to certificate of authenticity or provenance if available; sometimes details are found at the back of a painting or at the
bottom of a sculpture)

PHOTO:

I. BACKGROUND INFORMATION

A. TYPE: [ ]PAINTING [ ]SCULPTURE[ ]PRINTWORK

[ ]CARVING [ ]PHOTO [ ]SKETCH
[ ]DRAWING [ ]OTHER ______________________________

B. ARTIST:

C. NATIONALITY OF ARTIST:

D. DATE CREATED: (usually found near signature, back of painting or bottom or side of sculpture)

E. OWNER/COLLECTOR/ORIGIN:

F. PREVIOUS OWNER/S:

G. CURRENT OWNER:

H. ADDRESS:

II. DESCRIPTION

A. MEDIUM/MATERIAL:(e.g. oil or acrylic on canvas, watercolor or charcoal on paper, fiber cast, mixed media etc. refer to
certificate of authenticity, if available)

B. DIMENSIONS:(in Height:_______________ Width:___________________

_____________________________________________________________________________________

Significant Tangible Movable Heritage

Municipality/City of ________________________
Province of _______________________________
Region ___________________________________
Form 3E series January 2017

NATIONAL COMMISSION FOR CULTURE AND THE ARTS

SUBCOMMISSION ON CULTURAL HERITAGE
CULTURAL MAPPING PROGRAM
centimeters) Length:_______________ Diameter:________________

C. EDITION FROM ORIGINAL:

(if series; usually found near signature, e.g. 1/10 means it is the first of ten pieces)

D. SUBJECT:(e.g. portrait, seascape, cityscape, landscape, nude etc.)

E. PROVENANCE

III. STORIES/NARRATIVES/BELIEFS/PRACTICES ASSOCIATEDWITH ARTWORK

IV. SIGNIFICANCE

Indicate type of significance, e.g. historical, aesthetic, economic, social, political, spiritual and then explain

V. CONSERVATION

A. PHYSICAL CONDITION: [ ] YELLOWING [ ]FADING [ ]ACCRETIONS

[ ] STAINS [ ] FOXING (BROWN SPOTS) [ ] HOLES
  [ ] FINGERPRINTS [ ] CREASES [ ] MISSING PART
[ ] TEARS/BREAK [ ] BRITTLE ___________________
[ ] LOSSES [ ] ABRASION
  [ ] FOLDS [ ] MOLDS [ ] OTHER
[ ] WRINKLES [ ] INSECT INFESTATION ___________________
Remarks:

B. THREATS/ISSUES/CHALLENGES:

_____________________________________________________________________________________

Significant Tangible Movable Heritage

Municipality/City of ________________________
Province of _______________________________
Region ___________________________________
Form 3E series January 2017

NATIONAL COMMISSION FOR CULTURE AND THE ARTS

SUBCOMMISSION ON CULTURAL HERITAGE
CULTURAL MAPPING PROGRAM

C. CONSERVATION MEASURES:

VI. REFERENCES

KEY INFORMANT/S:  
REFERENCE/S:  
NAME OF PROFILER/MAPPER:  
DATE PROFILED:  

_____________________________________________________________________________________

Significant Tangible Movable Heritage

Municipality/City of ________________________
Province of _______________________________
Region ___________________________________