|  | Stock Receiving
--- | --- | ---

| Print Date | 10-OCT-2022
| Receiving Date | 10-OCT-2022

Reference: | REC-0000001 |
Remedy #: | REM- |
Remedy Date: | 2022-10-20 |
Send By: |  |
Received By: |  |

Sr# | Product | Serial/Part # | Unit | Qty
--- | --- | --- | --- | ---

Please acknowledge receipt by dating and signing copy of this form
Prepared By |  | Receiver Signature

Remarks Here

Prepared by |  |  |  | Date Time |