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UR Mail Courier Delivery Request Form

Date Order Placed: 09/25/2017 Time Order Placed: 02:03 am
Desired Work Date: Available for Pickup After*:  :   
Must Be Today?  Yes      No      Preferred
Contact Person: Department: 
Contact Phone:  FAO/Account #*: 
Contact Email:  *account number should NOT include the subcode
Pick Up From:
Deliver To:
What Are We Delivering For You?
 Bag(s)  Envelope(s)  Grey Tub(s)  Suitcase(s)
 Heavy Box(es)  Light Box(es)  Full Hamper(s)  Empty Hamper(s)
 Full Tray(s)  Empty Tray(s)  Full Mail Tub(s)  Empty Mail Tub(s)
Total Number of Items:
Other item(s) or information: