Letter Head of Shipper
Telex release Requisition Form
Vessel/Voyage: ____ _________________
Name of Shipper
Name of Consignee: ________________________________
B!L No.: ___________________________________________insert identification numbers, date and place of issue
Loading Port: ________ _________Place of Delivery: _______________________
We hereby request, in consideration for you accepting the surrender of the attached full set of properly endorsed, original bills of lading, that you release the subject cargo to above-mentioned consignee without the presentation of any original Bill of Lading. Attached please find the full set (I) original Bill of Lading which being duly endorsed by us in respect of subject consignment (s).
In consideration of your complying with our above request, we do hereby undertake to hold you, your servant and your agent free and harmless from any liability, loss, claim or whatsoever nature which you, your servant or your agent may sustain in connection with the above-mentioned request(s) and to indemnity you, your servant or your agent against all consequences of your so doing. In addition, we shall be responsible to bear any extra cost(s) and liability that may arise from the above subject request(s).
(Shippers Company Chop & Signature)