Truck shipping instructions
DATE SHIPMENT IS TO MOVE
Date
(form:02-21-2000)

PICK-UP ADDRESS Shipper name
Your e-mail
Street address
City
State or county
Zip code
Country
PHONE #

CONSIGN THIS SHIPMENT TO : Consignee name
Street address
City
State or county
Zip code
Country
PHONE #

NUMBERS OF PIECES
Please insert
number of items, a description of shipment and the weight in LBS
No. item LBS
No. item LBS
No. item LBS
No. item LBS
No. item LBS
INSURANCE

VALUE OF GOODS $

Dollars
ADDITIONAL COMMENT

    Please print this page before you submit the information and then send or fax it signed to this address:
STRAIGHTWAY INC
P O Box 74068
ROMULUS MI 48174 US
FAX: (734)710-9410

PLEASE CALL 1-800-729 2636 IF YOU HAVE ANY QUESTIONS CONCERNING THIS FORM
   
 

I authorize Straightway Inc to act as our shipping agent in the preparation of all documents necessary to export and ship the above-described material. Date :___________________ Signed :_______________________
Social security # :______________
Fed ID # :_________________
WE CANNOT BILL OVERSEAS FOR ANY REASON ! ! ! !
Send billing to :
______________________________________
______________________________________
______________________________________

Please fill out all fields before you send it or fax this order!

One call thatīs all!