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Overnight Express Request Form

DATE: AIR BILL #:______________________
DEPT.: WEIGHT: _______________________
SENDER: COST: _________________________
METHOD OF PAYMENT:
BILL SENDER:
BILL RECIPIENT:
NAME:
EXPRESS COMPANY (CHECK ONE):
* UPS
(CAN NOT DELIVER TO P.O. BOXES)
POSTAL EXPRESS
(METRO AREAS DELIVERY BY 3:00 P.M.)

* ($ 12.50 EXTRA FOR SATURDAY DELIVERY)
FUND:
DEPT ID:
ACCT #:
CLASS:
PROGRAM:
PRODUCT:
PROJECT:
OP UNIT:

TIME OF DELIVERY (CHECK ONE)
NEXT DAY AM: NEXT DAY PM: TWO DAY SERVICE: SATURDAY:

TO: NAME:

PHONE:

COMPANY:

STREET ADDRESS

2nd STREET ADDRESS

CITY:

STATE:   ZIP CODE:

COUNTRY:

AUTHORIZED SIGNATURE:
  (MUST HAVE SIGNATURE AUTHORITY)/

PRINT NAME:

YES: SIGNATURE RELEASE (only if you don't need a signature when the item is delivered)

YES: If you want a signature on delivery to residential address please check here. (Extra charge)