UPS SHIPMENT REQUEST
Please complete form and fax to 6588 by 12:00 noon to ensure same day shipment. If received after 12:00 noon, request will be processed next business day. Please contact Alecia Oldham at x6657 if you have questions or concerns.
SHIPPER INFORMATION:
NAME
NAME
EXT E-MAIL
EXT
E-MAIL
SPECIAL INSTRUCTIONS:
Example: Reference Number; Return Authorization Number;
Charge to Recipient/Third Party – If so, include UPS Account Number
SPECIAL INSTRUCTIONS: Example: Reference Number; Return Authorization Number; Charge to Recipient/Third Party – If so, include UPS Account Number_Row_1
SPECIAL INSTRUCTIONS: Example: Reference Number; Return Authorization Number; Charge to Recipient/Third Party – If so, include UPS Account Number_Row_2
SHIP TO INFORMATION:
COMPANY NAME
ATTENTION
ADDRESS
SUITEDEPARTMENT
CITYSTATE
ZIPPHONE
COMPANY NAME
ATTENTION
ADDRESS
SUITE
DEPARTMENT
CITY
STATE
ZIP
PHONE
SERVICE INFORMATION: CHECK ONE OF THE FOLLOWING
NEXT DAY AIR EARLY A.M. (BY 8:00 A.M.)2ND DAY AIR
NEXT DAY AIR (BY 10:30 A.M.)2ND DAY AIR A.M.
NEXT DAY AIR SAVER (BY 3:00 P.M.)UPS 3 DAY SELECT
GROUND SERVICE
OF
OF
OF
OF
PACKAGING:NUMBER OF PACKAGES:
UPS LETTERPACKAGE 1 WEIGHT
UPS PAKPACKAGE 2 WEIGHT
UPS TUBEPACKAGE 3 WEIGHT
MY PACKAGINGPACKAGE 4 WEIGHT
NUMBER OF PACKAGES:
PACKAGE 1 WEIGHT
PACKAGE 2 WEIGHT
PACKAGE 3 WEIGHT
PACKAGE 4 WEIGHT
INSURANCE REQUIRED:
YES ☐ NO ☐ IF YES, DECLARED VALUE
IF YES, DECLARED VALUE
INSURANCE
REQUIRED:
REFERENCE NUMBER:
PURCHASE ORDER NUMBER
PURCHASE ORDER NUMBER
HOW TO GET PACKAGE TO UPS:
DROP OFF AT UPS STOREGIVE TO UPS DRIVER
SCHEDULE PICK-UP**MUST COMPLETE SCHEDULING INFO
SCHEDULING INFORMATION:
PICK-UP DATESHIPMENT READY AT
PICK-UP BYBUILDING
FLOORROOM
TO
TO
PICK-UP DATE
SHIPMENT READY AT
PICK-UP BY
BUILDING
FLOOR
ROOM