CD-578 (12/02)
U. S. DEPARTMENT OF COMMERCE PERMANENT CHANGE OF STATION TRANSPORTATION SERVICE ORDER This is to confirm a request for the following transportation and related transportation services. This government shipment is subject to terms and conditions of 41 CFR 102-117 and 118, the Federal Travel Regulation and the applicable Tender of Service.
1. Date: 4. Issuing Office:
2. Travel Order: No..
3. Bill of Lading Number:
5. To
TRANSPORTATION SERVICE PROVIDER
6. Address:
Contact name Telephone
7. City:
8. State:
9 . ZIP:
FAX Complete name of Carrier, SCAC and address
10. POC Name:
11. Phone:
12. Fax:
13. Employee PCS Information From: Current Duty Station
Name: Address/New Duty Station:
To: New Duty Station
Current Home Address:
City: Home Phone: Current Duty Station (City & State): Work Phone:
State: Other Phone:
ZIP:
City: Requested Pack/Load Date: Estimated Weight:
State: Reporting Date:
Zip:
14. Privately Owned Vehicle (POV) Information
Year: License: Model: VIN: Color:
Email address:
15. Accounting Information:
Remarks:
16. HOUSEHOLD GOODS/POV CARRIER INFORMATION
Signature of Driver: Agent: Requested Pack/Load Date: Required Delivery Date: Authorized Weight: Storage in Transit Authorized Remarks: Date: Total Cost Estimate: Tender/Tariff: Bill Charges To: