Straight Bill Of Lading Template

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STRAIGHT BILL OF LADING
RECEIVED AT (Origin City, State)
DATE
FROM (Shipper, including "Account Of" information")
SHIPPER'S NUMBER
CONSIGNED TO (full name, street address, beneficial owner, etc.)
DESTINATION (City, State)
DELIVERY ADDRESS (When tariffs or memorandums so provide, furnish all necessary information to effect delivery)
ROUTE
DELIVERING CARRIER
CAR/TRAILER/CONTAINER/CHASSIS INITIAL & NO.
WHO WILL PAY CHARGES (Not applicable when section 7 is executed)
Shipper
Consignee
Other (Specify Full Name, Mailing Address
WEIGHT*
SHIPPER'S CERTIFICATION
DESCRIPTION OF ARTICLES SHIPPED (Special
(Subject to
Number of Packages
Marks and Exceptions)
Corrections)
RATE
This is to certify that the above named materials are
properly classified, described, packaged, marked
and labeled, and are in proper condition for
transportation according to the applicable
regulations of the Department of Transportation.
Per
WEIGHT REQUEST
Please Weigh Car
Do Not Weigh - Per Car Rates Apply
Do Not Weigh - Destination Weights Apply
Weight Agreement Applies
SHIPPER'S SPECIAL INSTRUCTION
IF CHARGES ARE TO BE
PREPAID INDICATE
Subject to Section 7 of Conditions
of applicable bill of lading, if this
HERE "TO BE PREPAID"
shipment is to be delivered to the
consignee without recourse on the
shipper, the shipper shall sign the
*IF THE SHIPMENT MOVES BETWEEN TWO PORTS BY A CARRIER BY WATER, THE LAW REQUIRES
TO APPLY IN
following statement.
THAT THE BILL OF LADING SHALL STATE WHETHER IT IS "CARRIER'S OR SHIPPERS WEIGHT"
PREPAYMENT OF THE
NOTE - Where the rate is dependant on value, shippers are required to state specifically in writing the agreed
CHARGES ON THE
The carrier shall not make delivery
of this shipment without payment of
or declared value of the property. The agreed or declared value of the property is hereby specifically stated by
PROPERTY DESCRIBED
freight and all other lawful charges.
the shipper to be not exceeding:
HERE ON.
APPLICABLE ONLY IN
RECEIVED $_______
CONNECTION WITH ELECTION
$
Shipper
AGENT OR CARRIER
NUMBER 1 ABOVE.
PROTECTIVE SERVICE:
Mech.
Pre-
Non Pre-
Protect. Ser. Not
Cooled Comm
Cooled Comm
Req'd
CHARGES ADVANCED
$_____________
Optimum temperature inside car, container or trailer
deg. Fahrenheit. Rule No._________
Signature of Shipper
SHIPPER'S SIGNATURE
AGENT'S SIGNATURE
SHIPPER'S POST OFFICE ADDRESS
DATE RECEIVED BY CARRIER
THANK YOU – For Shipping via South Kansas & Oklahoma Railroad
FORM 1004 (REV. 4/97)

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