STRAIGHT BILL OF LADING
ORIGINAL - NOT NEGOTIABLE

(Name of Carrier)           (SCAC)
Shipper
Number:
Carrier
Number:
Date:
TO:
Consignee*:
Street: 
City:
   State:
   Zip:
FROM:
Shipper:
Street: 
City:
   State:
   Zip:
No. of units & Container Type HM BASIC DESCRIPTION
Proper shipping name, Hazard class, Identification Number (UN or NA) per 172.01, 172.202, 172.203		TOTAL QTY.
(Weight, Volume, Gallons, etc.)		WEIGHT
Subject to
correction		RATECHARGES
(For carrier
use only)


  
  
  


  
  
  


  
  
  
PLACARDS TENDERED: YES NO
Remit COD
to address:

 $ per
   

__________________
(Signature)
COD Amount:
$


__________________
(Signature of Consignor)
COD FEE:
PREPAID
COLLECT
$
TOTAL CHARGES:
$
FREIGHT CHARGES
Prepaid, unless you check following box for freight collect:
SHIPPER:CARRIER:
PER:PER:
Date: