ALTECA Ltd.

 Competitive Edge Technology for the new millennium.

   
 
 

 

 

CHAIN OF CUSTODY RECORD
click here for the instructions for filling out the chain of custody record

Sample ID: ________________________________________
Sample Description: ________________________________________

Released By:   
Name/Company:
Signature:
Date/Time:
Shipped/Transferred Via:
Tracking #:
Notes:

--------------------------------
Received By:

Name/Company:
Signature:
Date/Time:
Notes:

--------------------------------
Released By:
   
Name/Company:
Signature:
Date/Time:
Shipped/Transferred Via:
Tracking #:
Notes:

--------------------------------
Received By:

Name/Company:
Signature:
Date/Time:
Notes:

--------------------------------
Released By:
   
Name/Company:
Signature:
Date/Time:
Shipped/Transferred Via:
Tracking #:
Notes:

--------------------------------
Received By:

Name/Company:
Signature:
Date/Time:
Notes:

--------------------------------
Released By:
   
Name/Company:
Signature:
Date/Time:
Shipped/Transferred Via:
Tracking #:
Notes:

--------------------------------
Received By:

Name/Company:
Signature:
Date/Time:
Notes:

--------------------------------
Released By:
   
Name/Company:
Signature:
Date/Time:
Shipped/Transferred Via:
Tracking #:
Notes:

--------------------------------
Received By:

Name/Company:
Signature:
Date/Time:
Notes:

--------------------------------
Released By:
   
Name/Company:
Signature:
Date/Time:
Shipped/Transferred Via:
Tracking #:
Notes:

--------------------------------
Received By:

Name/Company:
Signature:
Date/Time:
Notes: