FROM:
Date of Pickup
Appointment Required Time of Appointment:  
Shippers Full Name
Street Address
City
Province / State
Postal Code
Phone #
After hours Emergency Cell
Contacts
TO:
Date of Delivery
Appointment Required Time of Appointment:  
Consignee's Full name
Street Address
City
Province / State
Postal Code / Zip Code
Phone #
After Hours / Emergency Cell
Contacts
Third Party / Other Billing
Full Name
Telephone
Street Address
City
Province / State
Postal Code / Zip Code
Goods
No.
Skids
No.
Pieces
DG
Description of Goods & Special Instructions
Weight
LBS
Weight
KGS
Total Total
Total
LBS
Total
KGS
 
Please Check One if nothing is checked this shipment will go collect


If to be protected from heat or frost, mark temperature here

Fahrenheight Celcius

Declared Value

Maximum liability of $2.00 per pound unless declared valuation states otherwise.


Email (this is where your copy of the paperwork will be sent)
Additional email to send paperwork to:
When you click "submit" a copy of the completed paperwork will be sent to the above email adresses as well as to Vision Transportation as well as any other required recipients.