DELIVERY
RECEIPT BY CARRIER TO SELLER
Station
__________
Freight
Bill Number __________
Consignee
__________
Destination
__________
Route
__________ (point of origin to destination)
Received
of __________ (name of shipper) the following described articles in good order:
___________________________________________________
Waybill
from __________
Waybill
Date and Number __________
Full
Name of Shipper __________
Car
Initial and Number __________
Point
and Date of Shipment __________
Connecting
Line Reference __________
Previous
Waybill Reference __________
Original
Car Initial __________ and Number __________
Number
of Packages, Articles and Marks __________
Weight
__________
Rate
__________
Freight
__________
Advances
__________
Total
__________
Total
Prepaid: __________ Dollars ($__________)
Notice
Mailed __________ (date)
Date
of Delivery __________ (date)
Total
__________
Receipt
of Property Acknowledged by __________, Consignee.
This
receipt to be retained for station record when dated and signed by consignee.
Dated:
__________
_____________________________________________
Signature
