Counter Drop Off Sheet
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Counter Drop Off Sheet Form. This is a California form and can be use in Riverside Local County.
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Tags: Counter Drop Off Sheet, ACR 140P-AS4AD0, California Local County, Riverside
RIVERSIDE COUNTY RECORDER
COUNTER DROP OFF SHEET
(A) Name of Customer
(B) Telephone Number
(C) Date
(D)
TYPE OF DOCUMENT(S) (By Title)
(E)
Qty.
(F)
# Of
Copies
(G)
Type Of
Copies
(H)
Ck.#
(I)
Ck. Amt.
(J)
Cash Amt.
(N)
(Recorders Use Only)
Recorded Rejected
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Documents will be recorded in the order listed unless otherwise specified below
(K) Recording Instructions
(L) Signature of Customer
(M) Received by
(O) Rejected Documents, Copies, Receipt and/or Buck Slip
(P) Picked up On
(Q) Signature of Customer Receiving Items Circled Above
(R) Signature of Employee Returning Items Circled Above
SEE REVERSE FOR INSTRUCTIONS
ACR 140P-AS4AD0 (Est. 01/2005)
American LegalNet, Inc.
www.USCourtForms.com
INSTRUCTIONS FOR COMPLETING THE
COUNTER DROP OFF SHEET
CUSTOMER
A. Name
B. Telephone number
C. Date of drop off
D. List type of documents by title (documents with the same title being
paid by one check or in one total cash amount can be listed all
together on one line)
E. Quantity of documents
F. Number of copies requested
G. Type of copies requested (i.e. Certified, plain or conformed)
H. Check number
I. Check amount
J. Cash amount
K. Recording instructions
L. Signature
EMPLOYEE
M. Signature of employee receiving the items
N. Employee must check either the recorded or rejected box
O. After the documents have been recorded or rejected circle the items
being returned to the customer
P. Date of pick up
Q. Have the customers sign for receiving the items
R. Signature of employee returning the items
ACR 140P-AS4AD0 (Est. 01/2005)
American LegalNet, Inc.
www.USCourtForms.com
