Detailed Freight Pick-Up Form

Requester Details

Requester Information

Shipper

Consignee (Receiver) Information

Third Party Payer Information

Shipment Details

Additional Services

Send Confirmation Copy

I am the (select all that apply):

Shipper Consignee Other

Payment Terms

Prepaid Collect

Contact

Phone

Extension

Company Name

Additional Info

Street Address

Country

City

State

Zip Code

Contact Name

Phone

Fax

Reference No. for Pick Up

Pick Up Date

Shipment Ready

Dock Closes

Company Name

Additional Info

Street Address

Country

City

State

Zip Code

Contact

Phone

Fax

Company Name

Additional Info

Street Address

Country

City

State

Zip Code

Contact

Phone

Fax

# of Handling Units

Type

# of Packages

Type

Weight(lbs)

Class

NMFC(Item)

Sub

Cube(cuft)

Haz

Description

Declared Value

Transit Time Required

Pickup Options

Liftgate-At Pickup Inside Pickup Limited Access Pickup Residential Pickup Trade Show Pickup

Delivery Options

Construction Site Delivery Call Before Delivery Flatbed Delivery Liftgate-At Delivery Inside Delivery Limited Access Delivery Residential Delivery COD (collect for goods) Trade Show Delivery

Send copy of this Pickup Request to (check all that apply):

E-mail the Shipper E-mail the Consignee E-mail the Third Party

Send confirmation notice when shipment is picked up to (check all that apply):

E-mail the Shipper E-mail the Consignee E-mail the Third Party

Also send a copy of this Pickup Request to this email address:

Also send a confirmation notice when shipment is picked up to this email address:

Additional Instructions

I have read and agree to the Alliance Air Freight's Terms & Conditions of Contract. Please see link at bottom of page.

Yes I agree with the Terms & Conditions. No I do not agree with the Terms & Conditions.

12%

I am the (select all that apply):

Shipper Consignee Other

Payment Terms

Prepaid Collect

Requester Contact

Requester Email

Requester Phone

Extension

Shipper Company Name

Shipper Additional Info

Shipper Street Address

Shipper Country

Shipper City

Shipper State

Shipper Zip Code

Shipper Contact Name

Shipper Phone

Shipper Fax

Shipper Email

Reference No. for Pick Up

Pick Up Date

Shipment Ready

Dock Closes

Consignee (Receiver) Company Name

Consignee (Receiver) Additional Info

Consignee (Receiver) Street Address

Consignee (Receiver) Country

Consignee (Receiver) City

Consignee (Receiver) State

Consignee (Receiver) Zip Code

Consignee (Receiver) Contact

Consignee (Receiver) Phone

Consignee (Receiver) Fax

Consignee (Receiver) Email

Third Party Payer Company Name

Third Party Payer Additional Info

Third Party Payer Street Address

Third Party Payer Country

Third Party Payer City

Third Party Payer State

Third Party Payer Zip Code

Third Party Payer Contact

Third Party Payer Phone

Third Party Payer Fax

Third Party Payer Email

# of Handling Units

Type

# of Packages

Type

Weight(lbs)

Class

NMFC(Item)

Sub

Cube(cuft)

Haz

Description

Declared Value

Transit Time Required

Pickup Options

Liftgate-At Pickup Inside Pickup Limited Access Pickup Residential Pickup Trade Show Pickup

Delivery Options

Construction Site Delivery Call Before Delivery Flatbed Delivery Liftgate-At Delivery Inside Delivery Limited Access Delivery Residential Delivery COD (collect for goods) Trade Show Delivery

Send copy of this Pickup Request to (check all that apply):

E-mail the Shipper E-mail the Consignee E-mail the Third Party

Send confirmation notice when shipment is picked up to (check all that apply):

E-mail the Shipper E-mail the Consignee E-mail the Third Party

Also send a copy of this Pickup Request to this email address:

Also send a confirmation notice when shipment is picked up to this email address:

Additional Instructions

I have read and agree to the Alliance Air Freight's Terms & Conditions of Contract. Please see link at bottom of page.

Yes I agree with the Terms & Conditions. No I do not agree with the Terms & Conditions.

CALL NOW!

800-684-6359

800-684-6359

For immediate assistance with your shipping pick up, please call: 800-6-TIMELY (800-684-6359) or use our online chat support.

Detailed Freight Pick-Up Form

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