Grain Storage Receipt

___________ Company ____ day of ____ 20_____

No.________

Received of _________, bushels of ________, which has been received into store, to be stored with grain of the same kind and grade by inspection, and is deliverable to the order of said _______ upon the return of this receipt properly endorsed, and the payment of proper charges. Said company is not to be liable for loss or damage by fire or heating.

Secretary