Fill and Sign the Legal Form Acknowledgment of Delivery Warehouse Receipt

Acknowledgment of Delivery of Goods Pursuant to Warehouse Receipt Page 1 of 1 Acknowledgment of Delivery of Goods Pursuant to Warehouse Receipt (Date of Acknowledgment) To: (Name of Bailee) (Address of Bailee) The undersigned warrants that he is the person entitled to delivery of the goods under warehouse receipt no. , issued by you and dated , (Date) and here acknowledges the delivery and receipt of the property described in that document and any supplemental list as follows: . (Description of Property) The undersigned further warrants that the goods so received on this date were in apparent good order except as otherwise noted here: . (Description of Exceptions) The delivery and receipt of these items constitutes delivery of all goods owned by the undersigned and stored with the Bailee except as follows: . (Nature of Goods Remaining in Storage) Executed: [Date of Execution] (Signature) (Name of person entitled under document)
(name of bailee) (address of bailee) (town or city) (name of person to be notified of receipt of goods) (name of person to be notified if the goods have been removed from property listed in acknowledgment of delivery of goods) (street name) (stretch of road) (address at which property is to be delivered) (address where goods are to be delivered) (street or room number) (address to which goods are to be delivered). (title of goods) the undersigned further warrants that this title is not subject to any lien against any property, right, or interest therein and that the same is not encumbered by a lien except by this acknowledgment. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66