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Back to Forms for 'Bills of Lading'.


WAREHOUSE RECORD OF RECEIPT

WAREHOUSE RECORD OF RECEIPT

 

 

_________________________________________ (Name of Warehouse)

 

_________________________________________ (Address)

 

RECORD OF RECEIPT

 

Received from: _______________________________.

 

For account of: _______________________________.

 

Location: ___________________________________.

 

THIS IS NOT A WAREHOUSE RECEIPT

 

Description           Unit Value         Quantity                Total

__________        _________        __________        __________

__________        _________        __________        __________

__________        _________        __________        __________ 

 

Certification and Declaration

The undersigned having all right, title, and interest to transfer the property described below, hereby requests a ____________ (negotiable or nonnegotiable) warehouse receipt for such goods be issued in the name of __________ and sent to ________________________ of _______________________________ (address), ____________ (city), _____________ (county), ________________ (state).

 

The undersigned certifies that all quantities, weights, measure, makes, and descriptions including but not limited to values as stated on this document are true and correct. Liability of __________ (name of warehouseman) shall be limited to values as stated.

 

 

_______________________________________________________________

(Signature of Storer)

 

Warehouse Certification

Inspection having been made, goods listed in this record of receipt have been duly received in apparent good condition and the declarations of quantity, weights, descriptions, and value appear to be correct as stated by the storer.  Values are storers and warehouseman disclaims all liability and responsibility for them.

 

 

__________________________

(Warehouse Company)

 

 

_______________________

(Signature of Authorized Agent)



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