| 1: | Senders name and address |
| 2: | Senders contact name and phone number |
| 3: | Description of goods |
| 4: | Tick box if freight contains Dangerous Goods? |
| 5: | Sign consignment to accept terms & conditions |
| 6: | Receiver name and address |
| 7: | Receiver contact name and phone number |
| 8: | Total number of items |
| 9: | Weight of the entire consignmnet |
| 10: | Dimensions of all items |
| 11: | Date |
| 12: | Service required |
