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- ASSIGNMENT OF RECEIVABLE
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- FOR VALUE RECEIVED, the undersigned hereby conveys,
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- transfers and assigns to ______________________ all right, title
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- and interest in all moneys due or that may become due from
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- ____________________________ upon the annexed statement of
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- account.
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- The undersigned warrants (1) that no payment on the
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- annexed account has been made to the undersigned, by
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- ________________________; (2) that the amount set forth in the
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- annexed account is due and owing from ________________; and (3)
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- that ___________________ is not entitled to claim an offset,
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- defense or counterclaim and that no valid deduction may be made
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- by __________________ other than that which is set out in the
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- annexed account, if any.
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- Signed under seal this _____ day of __________,
- 19__.
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- ___________________________ _________________________
- Witness
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- Form 209
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