NEW YORK & WESTERN RAILROAD WAYBILL

PLACE SPECIAL SERVICE PASTERS HERE

A.R.503

   664- New York & Western Railroad- 664

Eight Part

FREIGHT WAYBILL

TO BE USED FOR SINGLE CONSIGNMENTS, CARLOAD, LESS CARLOAD & TOFC

TRANSFERRED TO CAR

KIND

WEIGHT IN TONS

LENGTH OF CAR

MARKED CAPACITY OF CAR

GROSS

TARE

NET

ORDERED

FURNISHED

ORDERED

FURNISHED

CAR INITIALS AND NUMBER

KIND

DATE OF SHIPMENT

WAYBILL NUMBER

TRAILER INITIALS AND NUMBER

LENGTH

PLAN NUMBER

TRAILER INITIALS AND NUMBER

LENGTH

PLAN NUMBER

CONSIGNEE AND ADDRESS AT STOP

AT

AT

AT

TO NO.

STATION

STATE OR PROVINCE

FROM

STATION

STATE OR PROVINCE

1

PATCHOGUE

NEW YORK

ROUTE (Show each Junction & Carrier in Routeorder to destination of waybill)

ROUTE CODE NO.

FULL NAME OF SHIPPER AND FOR C.O.D. SHIPMENTS, STREET

CODE NO.

POST OFFICE ADDRESS AND INVOICE NUMBER

RECONSIGN TO

STATION

STATE OR PROVINCE

ORIGIN AND DATE, ORIGINAL CAR, TRANSFER FREIGHT BILL &

PREVIOUS WAYBILL REFERENCE & ROUTING WHEN REBILLED

Authority

CONSIGNEE AND ADDRESS

CODE NO.

AMOUNT

WEIGHED

$

FEE

AT

$

GROSS

TOTAL

TARE

$

ALLOWANCE

NET

PICK UP SERVICE

DELIVERY SERVICE REQUESTED

IF CHARGES ARE TO BE PREPAID CHECK OR STAMP HERE "TO BE PREPAID"

WHEN SHIPPER IN THE UNITED STATES EXECUTES THE NON-RECOURSE CLAUSE OF SECTION 7 OF THE BILL OF LADING INSERT "YES.

Indicate by symbol in column provided * how weights were obtained for LCL shipments only R =Railroad, S=Shippers Tested Weight, E=Estimated Weigh and Correct T=Tariff

No. PKGS.

Descriptions of Articles, Special Marks and Exceptions

Commodity Code No.

*

WEIGHT

RATE

FREIGHT

ADVANCES

PREPAID

DESTINATION AGENT'S FREIGHT BILL No.

Outbound Agent Will Show Junction Stamps in Space and Order Provided Additional Junction Stamps and all Yard Stamps

FIRST JUNCTION

SECOND JUNCTION

THIRD JUNCTION

FOURTH JUNCTION