Special Shipping Instruction Request Form

Special Shipping
Instruction
Request
Form
If you have any questions please contact the Engineering
Services team. Fax or Email completed forms to the
number or address indicated below.
Phone: (901) 370-7132
Fax: (901) 370-7566
Email: meengsvc@ingrammicro.com
1 ACCOUNT NUMBER (Include all zeros) Date 2. Ingram Sales Rep. 3 Telephone Number & Ext. (Internal use only) Ingram SKU
4 Requestor Information 5 Ship to information
Reseller Account Name
Company
Contact Name
Address
City
State/Province
Zip Code
Country
Telephone No. Ext. Pager Number Pin # Fax
Number
E-Mail Address
Attn:
Address
City State/Province
Zip Code, Country
6 Specify any special shipping label requirements:
7 Specify any special packing requirements:
8 Specify any special requirements for palletizing:
9 Specify any special shrink wrapping requirements:
10 Specify any special delivery instructions:
11 Specify any special carrier requirements:
12 Specify any additional requirements:
Memphis Engineering Services
Form 4
rev. 07/31/00 1

Memphis Engineering Services
Form 4
rev. 07/31/00 2