NAME RFC ADDRESS LOCATION C.P.

LETTER OF POR
MAIL: CEL: FOLIO:

PLACE AND DATE OF ISSUE:

ORIGIN DESTINATION
SENDER OR SHIPPER TARGET

ADDRESS ADDRESS

WILL BE COLLECTED IN: DELIVERED IN:

DECLARED VALUE $: EXPECTED DELIVERY DATE OR TIME

DEAR
DESIGNATION AND/OR DESCRIPTION OF THE GOODS TO BE TRANSPORTED CUBIC METERS
WEIGHT

HAZARDOUS MATERIAL OR WASTE YES ( ) NO( ATTACH TICKET (IN S

QUANTITY CONCEPT OR DESCRIPTION OF THE SERVICE

UNIT OF MEASURE

TOTAL:
INDEMNIFICATION: (IN ITS
CASE)
REMARKS:
RECEIVED IN ACCORDANCE
(name and signature of addressee or authorized person)

SERVICE CONTRACT, WHICH COVERS THIS CONSIGNMENT NOTE, ON THE REVERSE SIDE OF THIS
CONSIGNMENT NOTE
 TE-TRASLADO

LITERS

U CASE)

AMOUNT

SERVICE CONTRACT, WHICH COVERS THIS CONSIGNMENT NOTE, ON THE REVERSE SIDE OF THIS
CONSIGNMENT NOTE
SERVICE CONTRACT, WHICH COVERS THIS CONSIGNMENT NOTE, ON THE REVERSE SIDE OF THIS CONSIGNMENT NOTE