Delivery Order

Request Pickup & Delivery

Fill out the form below and we'll get your shipment moving. For urgent requests call (704) 282-1600.

Request Details

Request Date *

Pickup Date *

Ready Time *

Delivery Date *

Service Type *

Sender

Company

Contact Name *

Phone *

Street Address *

City *

State

ZIP *

Receiver

Company

Contact Name *

Phone *

Street Address *

City *

State

ZIP *

Point of Contact

Name *

Phone *

Email / Notes

Package Details

Description of Contents *

Quantity *

Weight (lbs)

Length (in)

Width (in)

Height (in)

Declared Value ($)

Reference / PO Number

Authorization

By submitting this form you authorize Cargo704 LLC to arrange pickup and delivery of the described shipment.

Printed Name *

Date *

Fields marked * are required.