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Sender3 Reference

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Senders Account No.

Sender

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No.

office use
Sertdlrs Depot

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of ltems Gross Weight
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incIuding fuIl postcode

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ls lncreased LiabiliĘ Cover Required? YES
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l1Declared value for customs

YES, state amount here

this
explanation
cover

P/ease see reverse of
document for an
of standard liability

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saturday

lnternational

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1kg

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Despatch Date

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Top White: Drivers

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weight
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Description of Goods & Packaging/Special Delivery lnstructions

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Consignment received in good ordet, by
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Signature

collected bv

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