UPS Shipment Request

Date:

Package From:

  • Name:
  • Department:
  • Pro Card #:
  • Expiration Date:
  • Phone Ext:
  • Signature:

Package To:



Do not attempted to ship to a PO Box; a street address is required

  • Type of Service: Ground
  • # of packages to this address:
  • Type of Delivery: Commercial
  • Requires package phone number:
  • Requires package description:
  • Select Optional Services (Additional Insurance at .35 per $100)
  • Amount over $100:

A copy of this form will be returned to you with your receipt attached

SHIPPING/RECEIVING USE ONLY

  • Date Received by:
  • Shipping/Receiving:
  • CHARGES:
  • Date picked up by UPS:
  • Shipping Charges:
  • Weight:
  • Extra Insurance:
  • Zone:
  • Total Charges:

Print this page, then complete the requested information above and give it to the mailroom.