THIRD PARTY COLLECTION REQUEST
Third Party Request Number => TPR2015312020 Print This Form

Consignment Number Details
Consignment Number      
Third Party Number       

Collection Address Details
    Name
   Address1
   Address2
   Suburb
   PostCode
   Contact/Phone
    Country
Delivery Address Details
Receiver Name
   Address1
   Address2
   Suburb
   PostCode
   Country
   Contact Name
   Contact Phone
   Pieces 
   Description  

THIRD PARTY COLLECTION AUTHORITY
I/We hereby authorise Jet Worldwide to organise the above collection.
I/We understand the collection will be by a Jet Worldwide agent.
I/We accept the charges for the collection of above.

Signature:___________________________________            Date:__________