Driver Statement

Load Incident Narrative and Chain-of-Custody Statement

Load / Driver

Load L003 (503) | Driver DRV-003 | Settlement STL-003
Route: BlueLine Retail - Indianapolis, IN -> Lakeside Grocery - Atlanta, GA
Generated Date: 2026-05-04

I, DRV-003, submit this statement regarding load L003.

I accepted dispatch instructions for the route listed above and followed standard pickup, transit, and delivery procedures.

Observed condition and timeline: Dispatch exception=true; seal=Mismatch; pod=verified

Seal / POD observations: Seal status Mismatch; POD status verified.

I affirm this statement is complete to the best of my knowledge and is provided for claims and settlement review.

Driver Signature / Date

Witness or Dispatcher Signature / Date