Fill and Sign the Agreement Form

Consignment Agreement in the Form of a Receipt _____________________ (Name of Consignee) _________________________________________ (Street Address, City, State, Zip Code) _________ (Receipt Number) Received of _____________________ (Name of Consignor) , of _________________________________________ (Street Address, City, State, Zip Code), hereinafter called the Consignor, the following merchandise: _______________________________________________________________ (describe merchandise) . In consideration of receipt, we agree to hold such merchandise in trust for Consignor for the purpose of storing such merchandise free of charge, and selling it for the account of Consignor for cash in amounts not less than the amounts shown in the price schedule received with such merchandise, a copy of which schedule is attached to this receipt as Exhibit A. We agree to return the merchandise unused and in good condition to Consignor upon demand, or if sold, to keep the proceeds distinct and separate from our funds, and to account for and pay over the proceeds to Consignor after first deducting from such proceeds our commission for sales based on the following schedule: _______________________________________________________________ (describe commission schedule) WITNESS our signature as of the day and date first above stated. _____________________ (Name of Consignee ) By:_________________________ (Signature of Officer) _____________________ (P rinted Name & Office in Corporation)