DIY Legal Forms

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Warehouse Receipt

No. [receipt number]

[city, state]

[date]

1. Receipt. Received by [name] (Warehouse Person) on the account of [name] (Bailor) the following described goods: [description].

The Goods are to be stored in the warehouse located at [address] and are received upon the terms and conditions set out in this Receipt.

2. Delivery to Bailor or Order. The Goods will be delivered on demand to Bailor or Bailor's order at the warehouse described above.

[Alternative Paragraph A]

2. Delivery to Bearer. The Goods will be delivered on demand to Bearer of this Receipt at the warehouse described above.

[Alternative Paragraph B]

2. Delivery to Bailor. The Goods will be delivered on demand to Bailor at the warehouse described above.

3. Storage Charges. The rate of storage is ........ dollars ($.........) per month. The rate of storage for a fraction of a month shall be the full month's charge.

4. Warehouse person Is Owner of Goods. Warehouse person is Owner of the Goods.

[Alternative Paragraph]

4. Warehouseman Is Owner of Goods. Warehouse person is Owner of the Goods jointly with [name], with offices at [address].

5. Advances by Warehouse person.......... dollars ($........) has been advanced by Warehouse person on the Goods for which Warehouse person claims a lien.

[Alternative Paragraph]

5. Advances by Warehouse person. Advances have been made by Warehouse person on the Goods for the following purposes: [list of purposes].

Warehouse person claims a lien for these advances.

[name]

By: [signature]

Warehouse Person