U.S. DOC Form doc-cd-578

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U.S. DOC Form doc-cd-578
CD-578
(12/02)
U. S. DEPARTMENT OF COMMERCE
PERMANENT CHANGE OF STATION TRANSPORTATION SERVICE ORDER
This is to confirm a request for the following transportation and related transportation services.
This government shipment is subject to terms and conditions of 41 CFR 102-117 and 118, the
Federal Travel Regulation and the applicable Tender of Service.
1. Date:
3. Bill of Lading Number:
2. Travel Order: No..
4. Issuing Office:
TRANSPORTATION SERVICE PROVIDER
5. To
Contact name
6. Address:
Telephone
7. City:
8. State:
9 . ZIP:
FAX
Complete name of Carrier, SCAC and address
10. POC Name:
11. Phone:
12. Fax:
13. Employee PCS Information
From: Current Duty Station
To: New Duty Station
Name:
Address/New Duty Station:
Current Home Address:
City:
Home Phone:
State:
ZIP:
Other Phone:
Current Duty Station (City & State):
City:
State:
Requested Pack/Load Date:
Reporting Date:
Estimated Weight:
Work Phone:
14. Privately Owned Vehicle (POV) Information
Year:
Email address:
Model:
License:
15. Accounting Information:
Remarks:
16. HOUSEHOLD GOODS/POV CARRIER INFORMATION
Signature of Driver:
Date:
Total Cost Estimate:
Agent:
Tender/Tariff:
Requested Pack/Load Date:
Bill Charges To:
Required Delivery Date:
Authorized Weight:
Storage in Transit Authorized
Remarks:
Zip:
VIN:
Color:
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