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00001

YOUR COMPANY NAME Address / Phone

0-0000

Warehouse Receipt ORIGINAL - Negotiable

Grain Deposited_____________ Receipt Issued_____________

Scale Tkt. No.

GROSS

TARE

NET

Dkg. %

M/D/Y

DATE: Rec'd Of

_________________________________________________

M/D/Y

LOCATION & COUNTY DELIVERED TO

(Name)

(Address)

Write Out In Full___________________________________________________________________________________________ Net Bushels KIND OF GRAIN GRADE/CLASS TEST WT. DOCK % MOIST. % T.D. PROTEIN

Kind of Grain Test Wt.

GROSS POUNDS

OTHER QUALITY FACTORS

100s

BU.

Dock. Per Bu.



Grade

DOCK. NET ➲

E L

GROSS BUSHELS (100ths)

RECEIVED BY  TRUCK  RAIL  BARGE

NET POUNDS

STORAGE RATES

Per Bu. Per Day @

Net Price Amt. Pd. $

Amount of Indebtedness______________________________________

By_________________________________________________________ Agent

YOUR COMPANY NAME Address / Phone

0-0000



NET

Dkg. %

Warehouse Receipt

DATE: Rec'd Of

(Name)



A S Test Wt.

BU.

GROSS DOCK.

NET ➲

Date Purch. Net Price Amt. Pd. $

000,000 • Victor Lundeen Co., Printers, Fergus Falls, MN • 800-346-4870

GROSS

TARE

NET

Dkg. %

00002

_________________________________________________

M/D/Y

LOCATION & COUNTY DELIVERED TO

(Address)

Write Out In Full___________________________________________________________________________________________ Net Bushels KIND OF GRAIN GRADE/CLASS TEST WT. DOCK % MOIST. % T.D. PROTEIN

Kind of Grain

Scale Tkt. No.

M/D/Y

COPY - Not-Negotiable

SCALE TICKET Rec'd in Store for___________________________________________________________________________________________________ NUMBERS

Address:

Form 2232 - ND

CENTS

$

Storage Deductions $

ORIGINAL - Negotiable

Grain Deposited_____________ Receipt Issued_____________

TARE

DOLLARS

Amount

THIS GRAIN In Full Payment of the Grain Represented by this Warehouse Receipt. Net Amt. RECEIVED SUBJECT $ To Pay TO CONDITIONS ON Signed_______________________________________________________ Owner NET BACK HEREOF I hereby certify that I am the owner of the grain for which this receipt was issued, and that there are not liens, chattel mortgages, or other claims against the grain represented by this receipt. Form 2232 - ND 000,000 • Victor Lundeen Co., Printers, Fergus Falls, MN • 800-346-4870

00002

GROSS

PRICE PER BU.

GROSS

____________________________________________________________ Dollars STORAGE

P M

000,000 • Victor Lundeen Co., Printers, Fergus Falls, MN • 800-346-4870

For Redelivery @

Nature of Indebtedness______________________________________________________

Date:__________________ Check No._____________ For $__________________

Ck. No. Stor. Chgs. $

For Receiving @

Date Storage Pre-Paid Through (M/D/Y)_________________________

SETTLEMENT RECORD Rec'd From_________________________________________________________

Date Purch.

NET BUSHELS (100ths)

Amount of advances made and liabilities incurred for which the warehouseman claims a lien on the above described grain. (Show nature of indebtedness.)*

GROSS

Scale Tkt. No.

00001

SCALE TICKET Rec'd in Store for___________________________________________________________________________________________________ NUMBERS

Address:

Form 2232 - ND

COPY - Not-Negotiable

GROSS POUNDS

OTHER QUALITY FACTORS

100s

Dock. Per Bu.



GROSS BUSHELS (100ths)

RECEIVED BY  TRUCK  RAIL  BARGE

NET POUNDS

STORAGE RATES

Per Bu. Per Day @

For Receiving @

For Redelivery @

Amount of advances made and liabilities incurred for which the warehouseman claims a lien on the above described grain. (Show nature of indebtedness.)*

Grade

Date Storage Pre-Paid Through (M/D/Y)_________________________

Nature of Indebtedness______________________________________________________

Amount of Indebtedness______________________________________

By_________________________________________________________ Agent

SETTLEMENT RECORD Rec'd From_________________________________________________________ Date:__________________ Check No._____________ For $__________________

Ck. No. Stor. Chgs. $

NET BUSHELS (100ths)

PRICE PER BU.

DOLLARS Amount

GROSS

CENTS

$

Storage Deductions $

____________________________________________________________ Dollars STORAGE

THIS GRAIN In Full Payment of the Grain Represented by this Warehouse Receipt. Net Amt. RECEIVED SUBJECT $ To Pay TO CONDITIONS ON Signed_______________________________________________________ Owner NET BACK HEREOF I hereby certify that I am the owner of the grain for which this receipt was issued, and that there are not liens, chattel mortgages, or other claims against the grain represented by this receipt. Form 2232 - ND 000,000 • Victor Lundeen Co., Printers, Fergus Falls, MN • 800-346-4870

00003

YOUR COMPANY NAME Address / Phone

0-0000

Warehouse Receipt ORIGINAL - Negotiable

Grain Deposited_____________ Receipt Issued_____________

M/D/Y

COPY - Not-Negotiable

00003

_________________________________________________

M/D/Y

LOCATION & COUNTY DELIVERED TO

SCALE TICKET Rec'd in Store for___________________________________________________________________________________________________ NUMBERS

DATE: Rec'd Of

(Name)

(Address)

Write Out In Full___________________________________________________________________________________________ Net Bushels KIND OF GRAIN GRADE/CLASS TEST WT. DOCK % MOIST. % T.D. PROTEIN

Address:



Kind of Grain Test Wt.

BU.

OTHER QUALITY FACTORS

100s

Dock. Per Bu.

GROSS

Grade

DOCK.

NET ➲

Form 2232 - ND

000,000 • Victor Lundeen Co., Printers, Fergus Falls, MN • 800-346-4870



GROSS BUSHELS (100ths) RECEIVED BY  TRUCK  RAIL  BARGE

NET POUNDS

Ck. No. Stor. Chgs. $

NET BUSHELS (100ths)

STORAGE RATES Per Bu. Per Day @

For Receiving @

For Redelivery @

Amount of advances made and liabilities incurred for which the warehouseman claims a lien on the above described grain. (Show nature of indebtedness.)*

Date Storage Pre-Paid Through (M/D/Y)_________________________

Nature of Indebtedness______________________________________________________

Amount of Indebtedness______________________________________

By_________________________________________________________ Agent

SETTLEMENT RECORD Rec'd From_________________________________________________________

Date Purch. Net Price Amt. Pd. $

GROSS POUNDS

Date:__________________ Check No._____________ For $__________________

PRICE PER BU. GROSS

____________________________________________________________ Dollars STORAGE

DOLLARS Amount

CENTS

$

Storage Deductions $

THIS GRAIN In Full Payment of the Grain Represented by this Warehouse Receipt. Net Amt. RECEIVED SUBJECT $ To Pay TO CONDITIONS ON Signed_______________________________________________________ Owner NET BACK HEREOF I hereby certify that I am the owner of the grain for which this receipt was issued, and that there are not liens, chattel mortgages, or other claims against the grain represented by this receipt. Form 2232 - ND 000,000 • Victor Lundeen Co., Printers, Fergus Falls, MN • 800-346-4870

“All storage contracts on grain in store at public grain warehouses terminate on June thirtieth, as identified in the publication required by section 60-02-17. If storage charges and warehouseman’s advances remain unpaid at the time of termination, the warehouseman may sell a sufficient amount of grain to pay the charges and advances. The receiptholder shall surrender the receipt to the issuing warehouseman for settlement."

“This grain is received, insured, and stored subject to the laws and rules of the state of North Dakota, the terms of this contract, and the charges and conditions stated herein and as filed with the North Dakota public service commission. Upon surrender of this receipt and payment or tender of all applicable charges, the amount, kind, and grade of grain identified in this receipt will be delivered to the person named above or the person’s order as rapidly as due diligence, care, and prudence will permit. At the option of the holder of this receipt, the amount, kind, and grade of grain for which this receipt is issued, upon demand, must be delivered back to the holder at any terminal point customarily shipped to, or at the place where received, upon the payment of any charges for receiving, handling, storage, and insurance and in case of terminal delivery, the payment in addition to the above of the regular freight charges on the gross amount called for by this ticket or in lieu thereof, a receipt issued by a bonded warehouse or elevator company doing business at the terminal point. Nothing in this receipt requires the delivery of the identical grain specified herein, but an equal amount of grain of the same kind and grade must be delivered.” (SEC.60-02-17, Amend. - ND Century Code)

All grain remaining on storage after termination of this contract will be stored by the warehouseman subject to the storage rates and policies in effect on the date following termination.

“All storage contracts on grain in store at public grain warehouses terminate on June thirtieth, as identified in the publication required by section 60-02-17. If storage charges and warehouseman’s advances remain unpaid at the time of termination, the warehouseman may sell a sufficient amount of grain to pay the charges and advances. The receiptholder shall surrender the receipt to the issuing warehouseman for settlement."

“This grain is received, insured, and stored subject to the laws and rules of the state of North Dakota, the terms of this contract, and the charges and conditions stated herein and as filed with the North Dakota public service commission. Upon surrender of this receipt and payment or tender of all applicable charges, the amount, kind, and grade of grain identified in this receipt will be delivered to the person named above or the person’s order as rapidly as due diligence, care, and prudence will permit. At the option of the holder of this receipt, the amount, kind, and grade of grain for which this receipt is issued, upon demand, must be delivered back to the holder at any terminal point customarily shipped to, or at the place where received, upon the payment of any charges for receiving, handling, storage, and insurance and in case of terminal delivery, the payment in addition to the above of the regular freight charges on the gross amount called for by this ticket or in lieu thereof, a receipt issued by a bonded warehouse or elevator company doing business at the terminal point. Nothing in this receipt requires the delivery of the identical grain specified herein, but an equal amount of grain of the same kind and grade must be delivered.” (SEC.60-02-17, Amend. - ND Century Code)

All grain remaining on storage after termination of this contract will be stored by the warehouseman subject to the storage rates and policies in effect on the date following termination.

“All storage contracts on grain in store at public grain warehouses terminate on June thirtieth, as identified in the publication required by section 60-02-17. If storage charges and warehouseman’s advances remain unpaid at the time of termination, the warehouseman may sell a sufficient amount of grain to pay the charges and advances. The receiptholder shall surrender the receipt to the issuing warehouseman for settlement."

“This grain is received, insured, and stored subject to the laws and rules of the state of North Dakota, the terms of this contract, and the charges and conditions stated herein and as filed with the North Dakota public service commission. Upon surrender of this receipt and payment or tender of all applicable charges, the amount, kind, and grade of grain identified in this receipt will be delivered to the person named above or the person’s order as rapidly as due diligence, care, and prudence will permit. At the option of the holder of this receipt, the amount, kind, and grade of grain for which this receipt is issued, upon demand, must be delivered back to the holder at any terminal point customarily shipped to, or at the place where received, upon the payment of any charges for receiving, handling, storage, and insurance and in case of terminal delivery, the payment in addition to the above of the regular freight charges on the gross amount called for by this ticket or in lieu thereof, a receipt issued by a bonded warehouse or elevator company doing business at the terminal point. Nothing in this receipt requires the delivery of the identical grain specified herein, but an equal amount of grain of the same kind and grade must be delivered.” (SEC.60-02-17, Amend. - ND Century Code)



Charges may be waived per the elevator’s fee schedule in effect on the date of this receipt.



Charges may be waived per the elevator’s fee schedule in effect on the date of this receipt.





If any of the grain embraced in this receipt shall prove to be covered by a chattel mortgage or other lien, or the partial or absolute title shall prove to be in someone other than the person to whom this receipt was issued, the same, if discovered before the delivery of the grain, shall be sufficient reason for the refusal to deliver to the holder of the receipt, or if discovered after the delivery of the grain, such delivery shall be deemed an over delivery for which said holder of this receipt, to whom such delivery is made, shall be accountable. NDCC 60-02-18

The Undersigned hereby indorses this receipt and certifies that on the date stated he is the owner of the grain covered by this receipt and, other than the warehouse operator's lien shown on the face of this receipt, there are no liens, mortgages, or other encumbrances on said grain, as except as stated hereon.

DEPOSITOR'S ENDORSEMENT AND STATEMENT OF OWNERSHIP AND ENCUMBRANCES

_________________________________________________________

The Undersigned hereby indorses this receipt and certifies that on the date stated he is the owner of the grain covered by this receipt and, other than the warehouse operator's lien shown on the face of this receipt, there are no liens, mortgages, or other encumbrances on said grain, as except as stated hereon.

DEPOSITOR'S ENDORSEMENT AND STATEMENT OF OWNERSHIP AND ENCUMBRANCES

_________________________________________________________

_________________________________________________________

The Undersigned hereby indorses this receipt and certifies that on the date stated he is the owner of the grain covered by this receipt and, other than the warehouse operator's lien shown on the face of this receipt, there are no liens, mortgages, or other encumbrances on said grain, as except as stated hereon.

DEPOSITOR'S ENDORSEMENT AND STATEMENT OF OWNERSHIP AND ENCUMBRANCES

2232-ND Backer (Rev. 10/13) • Victor Lundeen Co., Printers  •  Fergus Falls, MN  •  1-800-346-4870

_________________________________________________________

_________________________________________________________

Subsequent Endorsements

Signed:___________________________________________________

(month, Day, Year)

_________________________________________________________

Subsequent Endorsements

Signed:___________________________________________________

(month, Day, Year)

_________________________________________________________

Subsequent Endorsements

Signed:___________________________________________________

(month, Day, Year)

_________________________________________________________

2232-ND Backer (Rev. 10/13) • Victor Lundeen Co., Printers  •  Fergus Falls, MN  •  1-800-346-4870



If any of the grain embraced in this receipt shall prove to be covered by a chattel mortgage or other lien, or the partial or absolute title shall prove to be in someone other than the person to whom this receipt was issued, the same, if discovered before the delivery of the grain, shall be sufficient reason for the refusal to deliver to the holder of the receipt, or if discovered after the delivery of the grain, such delivery shall be deemed an over delivery for which said holder of this receipt, to whom such delivery is made, shall be accountable. NDCC 60-02-18



If any of the grain embraced in this receipt shall prove to be covered by a chattel mortgage or other lien, or the partial or absolute title shall prove to be in someone other than the person to whom this receipt was issued, the same, if discovered before the delivery of the grain, shall be sufficient reason for the refusal to deliver to the holder of the receipt, or if discovered after the delivery of the grain, such delivery shall be deemed an over delivery for which said holder of this receipt, to whom such delivery is made, shall be accountable. NDCC 60-02-18

A S

_________________________________________________________

2232-ND Backer (Rev. 10/13) • Victor Lundeen Co., Printers  •  Fergus Falls, MN  •  1-800-346-4870

Charges may be waived per the elevator’s fee schedule in effect on the date of this receipt.

All grain remaining on storage after termination of this contract will be stored by the warehouseman subject to the storage rates and policies in effect on the date following termination.

P M

E L