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Sender3 Reference
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Senders Account No.
Sender
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No.
office use
Sertdlrs Depot
Co^/s/Gl/MFNrNol
of ltems Gross Weight
KG
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incIuding fuIl postcode
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Other Seruices - please specify
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Senf by
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ls lncreased LiabiliĘ Cover Required? YES
If
For the attention of
Telephone
l1Declared value for customs
YES, state amount here
this
explanation
cover
P/ease see reverse of
document for an
of standard liability
I Senaer's
Ver
saturday
lnternational
Pa@l
Expres
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5kg
Pack
1kg
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Despatch Date
xx
Time Collected
copy 2nd
couńel
Pack
No.
Accept Conditions of Carriage shown over
Top White: Drivers
ught
weight
5kg
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Description of Goods & Packaging/Special Delivery lnstructions
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Telephone
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Pink: customerTo Retain
Consignment received in good ordet, by
Receiver's
Signature
collected bv
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Name
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