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					VALU MERCHANDISERS COMPANY                                                                             SHIPPER - PREPACK - PALLET COMPONENTS
VENDOR: - THIS FORM MUST BE INCLUDED IN THE 'NEW ITEM PACKET' FOR ANY SHIPPER / PREPACK / PALLET-TYPE ITEM.
        - PLEASE COMPLETE ALL INFORMATION FIELDS EXCEPT THOSE DESIGNATED "VMC USE ONLY."
        - A SEPARATE FORM WILL BE REQUIRED FOR EACH VMC DIVISION IF THE ITEM CODES FOR THE SHIPPER OR THE COMPONENTS DIFFER BETWEEN DIVISIONS.


VMC DIVISION:       FORT SCOTT          MEMPHIS


REP. COMPANY                                                                                 VENDOR NAME


SHIPPER DESCRIPTION                                                                              VENDOR #


PACK (TOTAL EACHES IN SHIPPER)



VMC SHIPPER ITEM CODE                               SHIPPER UPC   -             -



SHIPPER COMPONENTS:                                                                                            (VMC USE ONLY)

    VMC                                        # EACHES/                              # CASES/                                     ZONE 1 SRP
 ITEM CODE               ITEM UPC               SHIPPER           DESCRIPTION         SHIPPER PACK      SIZE   GROSS SELL EACH UNITS        PRICE

                -                -                                                                                                     @

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                                                                                                       DATE SUBMITTED
         REP. SIGNATURE




                                                                                                                                           DATE     -   -
           VMC USE ONLY              VMC MANAGEMENT APPROVAL




                                                                                                                                                            SHIPPER 7/03

				
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