Facilities Services Shipping Form
Date: ________/_________/____________
PERSON MAILING PACKAGE
Name ________________________________________________________________________Phone ____________________________________________
Department Name _____________________________________________________________________________________________________________
Fund # ________________________Dept # _________________________ Project or Program Number ________________________________
RECIPIENT INFORMATION
Name ____________________________________________________________________________________________________________________________
Company Name ________________________________________________________________________________________________________________
Street Address (cannot ship to PO Boxes)____________________________________________________________________________________
City/State/Zip or Postal Code _________________________________________________________________________________________________
Country _________________________________________________________________________________________________________________________
Recipient Telephone Number _________________________________________________________________________________________________
SHIPPING AND PACKAGE DETAILS
FedEx UPS How fast do you want the package to arrive? _________________________________________________________
Maximum amount that can be billed to your department __________________________________________________________________
Declared value/Insurance required
Yes: ____________________ No Are you shipping liquids: Yes No
Package contains hazardous materials (such as dry ice, biological substances, etc):
Yes No
___________________________________________________________________________________________________________________________________
Special Instructions:
Proof of Delivery; Email address for POD: _______________________________________________________
Secondary email address for POD: _______________________________________________________
Signature Required
INTERNATIONAL SHIPMENTS
Content Description. Required — please be specific _______________________________________________________________________
___________________________________________________________________________________________________________________________________
SHIPPING OFFICE USE ONLY
Length______________________Width __________________________Height ___________________________ Weight _______________________
Phone: 701-858-4130
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