MILITARY FREIGHT WARRANT(AE Reg 55-355)

Date issued Serial number

Consignee (name, address, telephone number (DSN/civilian))Consignor (name, address, telephone number (DSN/civilian))

AE FORM 55-355F, NOV 04 Replaces AE Form 55-355F, dtd May 03, which will be used until stock is exhausted.

Tender number Via

Name of carrier License number of truck

Subcarrier

Name of driver, assistant driver, signature, date, hour

Spotted at loading point Spotted at offloading point

TimeDay TimeDay

Pulled Released

Totals Totals

Trailer

Accompanying documents (for example, customs documents, pallet ID, seal number, HHG weight slip)

Name, grade, title, address, telephone number of consignee

TMR Number

Address and number or marks(for example,

TCN, RF tag number) Quantity How packed Description of goods Actual gross weight

Name, grade, title, address, telephone number of consignor

Appropriation data (for example, fund cite TAC code)

Bill to Obligation authority

Date

Signature

Consignee's Certificate of DeliveryI certify that I have this day received from the trucker named in this certificate the public property described on this

Freight Warrant in apparent good order and condition except as noted in adjacent report of loss, damage, or shrinkage.

Date

Signature

Military Freight Warrant (Continuation sheet)Date issued Serial number

AE FORM 55-355F, NOV 04 (Back)

Tender number

Consignor Consignee

Address and number or marks (for example,

TCN, RF tag number) Quantity How packed Description of goods Actual gross weight

TMR Number