To
The Goods Superintendent,
……………………………………
……………………………………
In consideration of your having delivered to me the parcel No …………………containing valued at
Rs………………… consigned by M/s I Meerut station to me on or about
the…………………day of …………………20 the Railway Receipt in respect of which is
lost or misplaced, I hereby agree to indemnify you, the said Railway, its servants, harmless and
indemnified from and against all claims, demands, actions, proceedings, loss, damage, liabilities,
charges and expenses which may be made or brought or commenced against it or which you
may or may have to pay, incur or suffer as a result of your delivering the said parcel to us without
railway receipt.

Yours faithfully,

……………………