Copy _3_ of Request for Destination Bill of Lading

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REQUEST FOR DESTINATION BILL OF LADING Date: _________________ To: _________________________________________ (name of carrier) ____________________________________________ _____________________________________________ (address) REQUEST FOR ISSUANCE OF DESTINATION BILL OF LADING The undersigned consignor of the goods described below and delivered to you on __________ (month & day), _______ (year), for consignment to the order of __________ at __________ requests that instead of an order bill of lading be issued at the place of shipment, an order bill of lading be issued at the following destination: ____________________________________________________________________. This destination bill of lading, in standard form, should be issued as follows: Description of Articles: Special Marks Weight Number Class Rate _______________ ___________ ___________ __________ __________ _______________ ___________ ___________ __________ __________ _______________ ___________ ___________ __________ __________ Delivery of this bill of lading at the destination shall be made as follows: ___________ ____________________________________________________________________________________ ______________________________________________________. Please advise us on the issuance of this bill. _____________________________________________ (Name of Consignor) _____________________________________________ (Signature)

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