Booking Request Form

"**" indicates a required field

Contact Info

Co. Name:
**First Name:
**Last Name:

**E-mail:
Phone: () – Ext.
Fax: () –

Privacy: UTS will only use your information to contact you regarding your booking. Please view our privacy policy to learn more.

Shipper & Origin Info

**Shipper Name: As above
**Contact Name:
**Phone: () – Ext.
Fax: () –

**Do you need UTS to pick-up the shipment?
No, it will be delivered to your facility
Yes, please pick-up from the following location...

**Address:

**City	**State	**Zip Code

**Type of location picking up from:

**Is the shipment ready now?	**Shipping dept. hours:
Yes, it is ready now. No, it will be ready on...	Open: hrs Close: hrs
at hrs

Consignee & Destination Info

**Consignee Name: (recipient)
**Contact Name:
**Phone: () – Ext.

**Do you need UTS to deliver the shipment?
No, it will be picked up will call at your facility
Yes, please deliver to the following location...

**Address:

**City	**State	**Zip Code

**Type of location delivering to:

Description

+/–
Row

Handling Unit (HU)

**HazMat

**Contents (No. & kind of
packages and description)

NMFC
Class

NMFC
Item No.

**No.

**Type

**Dimensions (inches)
Length x Width x Height

**Weight (lbs)
per HU

x x

---- Shipment Totals --------

Additional Instructions

PO No:	Quote No:
Shipper's No:	Load No:

Additional shipment requirements or specifics: For example, here you can tell us about unique piece types, non-standard pick-up locations, special handling, or important dates, etc.

Billing Instructions

**Freight Charges:

**Bill to:
**Address:

**City	**State	**Zip Code

Submit Booking

If you are not taken to our confirmation page, please call us at (800) 926-6550, Monday through Friday, 8AM to 5PM (PDT), to ensure that we are aware of your booking request.

LDT	Guam	Pacific	Hawaii
Date Time

Universal Transportation Services

Forwarding Freight to Hawaii since 1983

Booking Request Form