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: