Bill of Lading
Ship Date: _____/_____/______
Deliver Date: ____/____/______
TO:
FROM:
Name: ___________________________________
Shipper: ________________________________
Street: ___________________________________
Street: _________________________________
Dept.: ___________________________________
Dept.: _________________________________
City/State/Zip: ____________________________
City/State/Zip: __________________________
For Payment, Send Bill To:
Shipper’s Instructions:
Name: ___________________________________
____________________________________
_
Company: ________________________________
_______________________________________
Address: _________________________________
_______________________________________
City/State/Zip: ____________________________
_______________________________________
Number of Shipping Units
Time
Description of Items
Weight
Rate
Charges
______________________
____
_________________
______
____
______
______________________
____
_________________
______
____
______
______________________
____
_________________
______
____
______
______________________
____
_________________
______
____
______
Remit C.O.D.
C.O.D. Amount:
C.O.D. Fee
______________________
_________________
[__] Prepaid [__] Collect
Total Charges: $_________
__________________________________________________________
Date____________
Signature of Consignee
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