Attention: _______________________FAX #:____________ Pages:____

 

Auto Express
562 East Woolbright Rd., Suite 210
Boyton Beach, FLA, 33435

Toll Free: 1-800-237-7398  Fax: 561-292-3788

 

Pick Up Information:

Name:____________________________ City & State:___________________

Street Address:__________________________________

Telephone Numbers: Home:____________Work:____________ EXT:_______

Cell:_____________ Alternate Contact & Telephone:_____________________

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Delivery Information:

Name:_____________________________ City & State:__________________

Street Address:___________________________________

Telephone Numbers: Home:____________ Work:___________ EXT:_______

Cell:______________ Alternate Contact & Telephone:____________________

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Vehicle Information:

Year:_________ Model:_________________ Make:_______________

Last 8 digits of VIN#_____________________

Other:___________________________________________________

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Payment Information:

All payments MUST be in the form of an ‘Official Bank Cashier’s Check’, an ‘United States Postal Money Order’,‘Western Union Wire Transfer’ or ‘Cash’. NO PERSONAL OR CERTIFIED CHECKS WILL BE ACCEPTED. Deposit must

Accompany this Shipping Order or in the case of orders returned by FAX, payment must be received in our office before this order is processed. ALL CANCELLED ORDERS FORFEIT THE TOTAL AMOUNT OF THE LISTED DEPOSIT.

 

TOTAL AMOUNT DUE:_____________ REQUIRED DEPOSIT:___________ BALANCE DUE:_________

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AVAILABILITY:

You must allow AT LEAST a 7 day period for the pick up of the vehicle, from the first day that the vehicle becomes available OR from the day that we have received BOTH the shipping Order and the deposit in our office. We do not pick up vehicles on a specific day, time, or location. In the following space please let us know when the vehicle is available based on the information above:

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This shipping order is provided as a service only. Unless otherwise noted, all terms and conditions are subject to the Uniform Bill of Lading which is issued at the point of pick up by the Carrier and the Carrier assumes all responsibility and liability therein stated.

Please see the reverse side or second page of FAX for additional Terms and Conditions. By signing and/or returning this Shipping Order, it is understood that all of the information has been reviewed and accepted.

Please sign and return to Auto Express:_______________________________________

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*When retuning by FAX - send this sheet only.** **Quote good for 30 days.**