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Request For Delivery Of Goods Without Surrender Of Document



REQUEST FOR DELIVERY OF GOODS WITHOUT SURRENDER OF DOCUMENT

Date: [Date of notice]


[First Name of person being notified] [Last Name of person being notified]
[Title of person being notified]
[Company of person being notified]
[Address of person being notified]
[City of person being notified], [State of person being notified]
[Zip Code of person being notified]

REQUEST FOR DELIVERY IN ABSENCE OF DOCUMENT

Dear [Mr./Mrs.] [Last Name of person being notified]:

The undersigned [owner or consignor or consignee], hereby requests that you deliver to the undersigned at [Shipment address], [Shipment city], [Shipment state] the following described goods in your possession pursuant to [document of title] no. [Title Number], dated [Date of title], covering the following goods: [Description of goods].

This request is made without surrender of the document since the document is missing as it was [lost or stolen or destroyed] under the following circumstances: [Description of loss].

An affidavit of loss executed by the undersigned is attached to this request.

Undersigned is prepared on request to post a security bond in the amount of at least two times the value of the goods at the time of posting of the bond, to indemnify any person injured by the delivery who files a notice or claim within one year after delivery. The undersigned agrees to pay all reasonable charges in connection with delivery of the goods and to hold you harmless from any liability in connection with the release of these goods as requested.



Signature of person seeking delivery Date


This is a UCC Business and Trade provision. It is designed to supplement UCC
"Shipping-Storage" forms found in this category.