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 (Q) Signature of Customer Receiving Items Circled Above (R) Signature of Employee Returning Items Circled Above (P) Picked up On SEE REVERSE FOR INSTRUCTIONS ACR 140 (Est. 01/2005) American LegalNet, Inc. www.FormsWorkFlow.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 140 (Est. 01/2005) American LegalNet, Inc. www.FormsWorkFlow.com