Pickup Request

Shipper Name:

Contact Name (optional):

Address Line 1:

Address Line 2 (optional):

Shipper Country:

Shipper Zip Code:

Shipper City/State:

Shipper Phone:

Ext:

Shipper Email:

Contact Name:

Company Name (optional):

Contact Phone:

Ext:

Contact Email:

Country:

Zip Code:

City/State:

Weight:

Pieces:

Pickup Date:

Ready Time:

Close Time:

Total Weight (lbs):

Total Pieces:

Food

Poison

HazMat

Freezable

Additional Instructions:

Standard Service
The value you've come to expect from R+L Carriers at an affordable price.