SHIPMENT RATE REQUEST FORM

(Fill in as completely as possible) * = required


Transport Method

Service Type


S/N Commodity Number of Pieces Weight per piece
Dimensions
1
2
3
4
Palletized ?
Shipment date:
Insurance (if desired) Declared Value (for Customs)

Cargo Point Of Origin

Company Name: Airport / Seaport:
Contact Name: Ship From Address:
City: State / Province:
Country : Phone: *
Fax: Email: *

Consignee Information:

Company Name: Airport / Seaport:
Contact Name: Ship From Address:
City: State / Province:
Country : Phone: *
Fax: Email: *
How did you hear about us? Comments: