U.S. National Logistics Group LLC
Name: Company Name: Phone Number: Email Address: Address:
Pickup Location: Delivery Location: Pickup Date & Time: Delivery Date & Time: Type of Freight: Description of Goods: Number of Pieces/Pallets/Containers: Dimensions (L x W x H per item): Total Weight:
Type of Truck/Trailer Needed (e.g., Dry Van, Reefer, Flatbed, Tanker): Special Handling Requirements (e.g., Liftgate, Inside Delivery, Temperature Control): Load Type: FTLLTL Insurance Requirements:
Freight Packing & CratingWarehousing & StorageExpedited ShippingCustoms Clearance
Quote Amount (if provided): Payment Terms (Prepaid, Net 30, etc.): Preferred Payment Method:
Special Instructions: Terms & Conditions Agreement:I Agree
Signature: