COMPLETE ALL INFORMATION AND ATTACH LOOSELY TO PARCEL
(incomplete forms will result in the parcel being returned to sender)
PLEASE PRINT
DATE:
__________________________
DEPARTMENT ACCT #
:_______________________________________________(MUST BE FILLED IN)
SENDER:
____________________________________________________________
DEPARTMENT:
____________________________________________________________
PHONE #:
_______________________________________________
RECEIVER (TO):
NAME/ATT:
___________________________________________________________
COMPANY:
___________________________________________________________
ADDRESS:
___________________________________________________________
(MUST HAVE STREET # as UPS cannot deliver to P.O. boxes)
CITY:
___________________________________________________________
PROVINCE/STATE: __________________________________________________________
POSTAL /ZIP CODE: _________________________________________________________
PHONE #:
___________________________________________________________
BILL TO RECEIVER COURIER ACCT #_____________________________________
(COLLECT SHIPMENTS ONLY)
VALUE OF PACKAGE $_________________ DANGEROUS GOODS ____Y / N_______
SERVICE:
AIR □
GROUND □
SATURDAY
□
9:00AM
OR 10:30AM
□
□
FOR SHIPMENT OUTSIDE OF CANADA, MUST LIST DETAILED CONTENTS OF
PACKAGE.____________________________________________________________________