Authentication And Apostille Certificate Order Form Page 4

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Wisconsin Office of the Secretary of State
Federal Express Return Shipment Order Form
If you would like your shipment sent back via Federal Express (FedEx), please fill out the form below
and we will enter the information for you, or if you prefer, you can go to the FedEx, United Parcel
Service (UPS) or United States Postal Service (USPS) website and order an air bill with your credit
card.
Shipping Address
Billing Address
 Same as Shipping Address
Name____________________
Name____________________
Address 1_________________
Address 1_________________
Address 2_________________
Address 2________________
City______________________
City______________________
State_____________________
State____________________
Country if not USA___________
Country if not USA__________
Zip Code__________________
Zip Code_________________
Phone #___________________
Phone___________________
 Residence  Business
Service Type
US Service
International Service
Special Handling
 First Overnight
 No Signature
FedEx account holders only
 Priority Overnight
 International First
 Direct Signature
 Standard Overnight
 International Priority
 Indirect Signature
 2-Day
 International Economy
 Express Saver
 Saturday Delivery
 Saturday Delivery
Payment Type
Credit Card Type
FED EX WILL NOT ACCEPT DEBIT CARDS!!
 American Express
Credit Card #_____________________________
 Visa
Security ID # _____
 Master Card
Expiration Date ______/_______
 Discover
E-mail Address __________________________
 Diner’s Club
OR
FedEx Account #___________________________________
Signature_____________________________________ Date __________

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