Agreement To Indemnity For Lost Receipt
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AGREEMENT TO INDEMNITY FOR LOST RECEIPT
I, MR____________________________,
aged _________ years,
son of____________________________________
resident of _____________________________________________________, hereby acknowledge to have received (state the article or cash which may have been received), the receipt for which I have lost and for myself, my heirs, executors and administrators, I undertake in consideration of such delivery or payment to hold __________________________________ its agents and servants, harmless and indemnified in respect of all claims to the said goods/articles/money;
Aand
I, MR. ____________________________,
aged _____________________________________ years,
son of ____________________________________,
resident of _________________________________________________, the undersigned, signing below the said _______________________________________, the recipient of these goods/articles or money, certify that the first signer is the bona fide owner and that I__________,..., the second signer stand surety and undertake the whole of the said liability equally with the recipient and for this purpose I also affix my signature hereto.
Witnesses:
SIGNATURE________
Recipient.
SIGNATURE__________
___________ ....

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