DATE OF SHIPMENT: CUSTOMER NAME: BOL #'s: SHIPPER NAME: CONSIGNEE #1: CITY, STATE: CONSIGNEE #2: CITY, STATE: CONSIGNEE #3: CITY, STATE: CONSIGNEE #4: CITY, STATE: CONSIGNEE #5: CITY, STATE: P.O.#'s: STEVENS INVOICE #: STEVENS LOAD #: TRACTOR #: TRAILER #: YOUR NAME: RETURN PHONE #: RETURN FAX#: RETURN E-MAIL ADDRESS: