Commercial Invoice

Pick Up Details

Pickup Date: *

At/Between: *

From Time: *

To Time: *

Sender's Account Number:

Email Address *

Pickup Location: *

Contact Name: *

Contact Phone Number: *

Pickup Street Address: *

Pickup City: *

Pickup State: *

Pickup Zip Code *

Pick up Country: *

Deliver BY/ON *

Deliver Date: *

At/Between *

From Time: *

To Time: *

Customer Reference Number

Delivery Details

Deliver to Location: *

Contact Name: *

Contact Phone Number: *

Deliver to Street Address: *

Deliver to City: *

Deliver to State: *

Deliver to Zip Code *

Deliver to Country:

Pieces: *

Weight: *

Dimensions: *

L x W x H

Service Level: *

Item Description

Number of Items (cartons)

Insured Value: (total shipment)

Special Instructions:

I certify that this shipment does not contain any unauthorized explosives, destructive devices or hazardous materials. I consent to a search of this shipment. I am aware that his endorsement and original signature, along with other shipping documents, will be retained on file.

Name