Express company receipt. Received from _________ subject to the classifications and tariffs in effect on the date of this receipt, _________[description of property], value stated and warranted by shipper to be $_____. Consigned to _________ at _________. Charges collect. Which the company agrees to carry upon the terms and conditions printed on the back of this receipt, to which the shipper agrees, and as evidence of which, accepts and signs this receipt.