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RPI form vietnam english PRG 040913

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Customer Service
Phone: Domestic toll free: 1800-585835 (press 1)
Int’l contact: 848-39480 370 (press 1)

REMOTE PICKUP REQUESTDate:

Fax: 848-39484 705
Email:

.

.

PLEASE EMAIL BACK TO:
We are glad to assist you in arranging the pickup of your shipment abroad. Please note our pickup service depends on the local procedure and package
readiness at origin. The information mentioned below will be entered in our worldwide booking system. Please ensure the information is accurate,
complete and all necessary paperwork is ready. If the pickup request is accepted, it is your responsibility to alert the sender that FedEx will be picking
up the shipment.

Please arrange pickup from the following address:
Company Name:
Address + Country:

Postal Code/ZIP:
Contact Person:
Telephone number:
Cellular/Mobile number:
Email address:
Commodity:
(Optional) Package ready as from (date):
Service Type Requested:





.

International Priority
International First
Weight per package


Declared Value for Customs
Currency:



and time:

.

:

(pickup time as per local procedure)

International Priority Freight
International Economy Service (IES); if applicable

kg
lbs

Dimensions per package






inches

cms

Number of Packages/Skids

(Optional) Declared Value for Carriage
Currency:

Please Deliver To:
Company Name:
Address + Country:

Postal Code/ZIP:
Contact Person:
Telephone number:
Cellular/Mobile number:
FedEx Account number
to be charged:
My FedEx Account Number
(if different from payor):
My name and
direct phone number (ext):
My email address (to receive
confirmation of booking #):

I agree that the determination of the final chargeable weight of the shipment will be made by FedEx and further agree to be liable for all charges and
fees related to this shipment, if so designated or in case a designated payor refuses any payment.

Send

Signature:

Company Stamp:



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