Agreement To Indemnity For Lost Receipt

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__________ 
___________ ....