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Get Da Form 5811 1989-2024

S 1-5 below were as stated. Circumstances of the loss or damage are accurately described below. 4. ITEM WAS (Check) 6. 1. 2. 3. STOCK NO. DESCRIPTION QUANTITY a. LOST b. DAMAGED 5 DAMAGED BY NEGLIGENCE? (Check) a YES b NO CIRCUMSTANCES OF LOSS OR DAMAGE 7a. SIGNATURE 7b. DATE PART II - ACTION 8. I have reviewed the evidence pertaining to the loss or damage as stated. I agree do not agree was not that the loss or damage to the class 5 item (s) was due to negligence, willful miscond.

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