Section 1: Shipper Account Number- Enter your Quick International account number. Section 2: Shipper’s Reference- Enter your own reference code for billing purposes. Section 3: Bill Consignee Account Number- Enter consignee’s account number if consignee is being billed for consignment. Section 4: Bill Other Account Number- Enter account number of client (if other than shipper) that the consignment is being billed to. Section 5: Pick Up Information- To be filled out by Quick’s driver or agent picking up the consignment. The driver or agent will enter his agent number, date and time of pick up. Section 6: Delivery Information- To be filled out by Quick’s driver or agent delivering the consignment. The driver or agent will enter his agent number, date and time of delivery. Section 7: Pick Up Address- Enter complete address of shipper. Section 8: Consignee Address- Enter complete address of consignee. Please include name and phone number. Section 9: Description/Commodity- Enter what the consignment consists of. Section 10: Pieces- Enter the number of pieces your consignment consists of. Section 11: Weight- Enter the total weight of your consignment. Section 12: Insurance- Enter an "x" in the box for the type of insurance desired. If you request more than the basic $200, check the box for additional insurance. For additional insurance please call your local Quick International office. Section 13: Special Instructions- Enter any special instructions you have regarding your consignment. Section 14: Part 109 Compliance/Shipper’s Certification- Please sign your name and date and submit two forms of ID to the Quick driver to comply with FAA regulations. Section 15: Shipper’s Signature/Date & Time- Enter signature of shipper, along with date and time that the shipment is ready. Section 16: Consignee’s Signature/Date & Time- Consignee’s signature is required, along with the date and time for proof of delivery purpose.