Trust Receipt Form No : ________________

Date Issued : ________________

Place Issued : ________________

TRUST RECEIPT AGREEMENT

Received in trust from _____________________________(ENTRUSTER) the

following goods per order of the undersigned ENTRUSTEE:

Quantity Description Unit Price Amount

Total: Php ________________

DUE
DATE:_______________

Undersigned ENTRUSTEE hereby agrees, undertakes and commits to hold in

trust for the ENTRUSTER the above goods, to dispose of or sell them for cash and
receive the proceeds thereof in trust for the ENTRUSTER, to turn over and remit the
proceeds of the sale of the goods to the ENTRUSTER on or before the above due
date, at the net amount indicated above.

The ENTRUSTER may cancel this trust receipt agreement and take possession
of the above goods or of the proceeds realized therefrom at any time upon default or
failure of the undersigned ENTRUSTEE to comply with any of the terms and conditions
of this trust receipt agreement.

Any court action arising from this agreement, the same shall be brought in the
proper court of Bacolod City to the exclusions of all other courts.

________________________________
(ENTRUSTEE’s printed name and signature)

_________________________________
Address