Name:
Address:
City/State:
Zip:
Phone:
Name:
Address:
City/State:
Zip:
Phone:
Prepaid
Collect
3rd Party (Must be prepaid)
Name:
Address:
City/State:
Zip:
Phone:
Single Shipment?
  Yes   No
Declared Value:
per
COD Amount: $
Consignee check OK?
  Yes   No
COD fee:
  Prepaid   Collect

Qty HM Description Weight Class/Rate