Shipping Questionnaire

Company/Shop Name *

Contact Name *

Phone Number *

Email Address *

Ship From Street Address *

Ship From Street Address Line 2

Ship From City *

Ship From State *

Ship From Zip Code *

Hours of Operation/Availability for Pick Up *

Requested Pickup Date(s) *

Requested Pickup Date Alternate

Shipping From Business/Commercial
Residential
Dropping the shipment off at the Shipping Terminal

Is a Lift-Gate Needed to Load Transmission onto the Truck? Yes, a liftgate is needed
No, a liftgate is not needed

How Will The Transmission Be Secured? Pallet
Inside a Box
Other

If Other Please Explain

Shipment Dimensions (L, W, H) *

Shipping Weight (lbs) *

Are you shipping the converter with the transmission? (If so, please secure it to the shipment separately. Do not leave it in the transmission.) Yes, I am shipping the converter with the transmission

Do you want the transmission returned to the same address as above? Yes, return the transmission to the same address as above?

Ship To Street Address *

Ship To Street Address Line 2

Ship To City *

Ship To State *

Ship To Zip Code *

Ship To Country *

By checking this box I understand that I will be responsible for any
accessorial charges imposed by the carrier due to inaccurate information
provided by me on this form. Examples of accessorial charges are things
like lift-gate service, residential and/or limited access delivery. *

Shipping Questionnaire

Contact

Company Info

Customer services

My account

Shipping Questionnaire

Contact

Social

Company Info

Customer services

My account