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Shipper Information
Company Name:
*Contact Name:
Address 1: *Phone:
Address 2: Fax:
Address 3: *Email:
Address 4: Web Address:
City:    
State:     
Postal Code:    
Service Required
  Ocean Air
  Door to Port
Port to Port
Door to Door
Port to Door		 Door to Terminal
Terminal to Terminal
Door to Door
Shipment Information
Service Requested:
 Truck Expedited Service Special Handling
Insurance Required:
 Yes No
Commodity:
 - New Used
Origin:
Destination:
Value: $
Number of Pieces:
Weight lbs:
Weight kilos:
Hazardous:
 Yes No
Container Size:
International Shipments
No. of Pieces Dimensions No. of Pieces Dimensions
1.
L x   W x  H
2. 
L x   W x  H
3.
L x   W x  H
4. 
L x   W x  H
5.
L x   W x  H
6. 
L x   W x  H
7.
L x   W x  H
8.  
L x   W x  H
9.
L x   W x  H
10.
L x   W x  H
Domestic Shipments
No. of Pieces Dimensions No. of Pieces Dimensions
1.
L x   W x  H
2. 
L x   W x  H
3.
L x   W x  H
4. 
L x   W x  H
5.
L x   W x  H
6. 
L x   W x  H
7.
L x   W x  H
8.  
L x   W x  H
9.
L x   W x  H
10.
L x   W x  H
Pick Up:
Delivery:
 Prepaid Collect
Tarping Required: Yes No
Instructions:
 
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Drake International, Inc. | 175 Carnegie Place Ste. 129 | Fayetteville, GA 30214
Phone: 770.991.2274 | Fax: 770.991.5244
©2002, 2006 Drake International, Inc.