Customer Service Phone: 54 11 46300300 Fax: 54 11 46300380 Email: rpisouthcone@mail.fedex.com REMOTE PICKUP-REQUESTDate: . . PLEASE EMAIL BACK TO: rpisouthcone@mail.fedex.com We are glad to assist you in arranging the pickup of your shipment abroad. Please note this service is not guaranteed as our pickup service depends on the local procedure and package readiness at origin. The information mentioned below will be entered in our worldwide booking system. Please ensure the information is accurate, complete and all necessary paperwork is ready. If the pickup request is accepted, it is your responsibility to alert the sender that FedEx will be picking up the shipment. Please arrange a pickup from the following address: Company Name: Address + Country: Postal Code/ZIP: Contact Name: Telephone number: Cellular/Mobile number: Email address: Commodity: Package ready as from date: . . and time: : (pickup time as per local procedure) Service Type Requested: FedEx International First® FedEx International Priority® FedEx® International Economy Service (IES); if applicable FedEx® International Priority Freight Weight per package Declared Value for Customs Currency: kg lbs Dimensions per package cms inches Number of Packages/Skids Declared Value for Carriage Currency: Please Deliver To: Company Name: Address + Country: Postal Code/ZIP: Contact Person: Telephone number: Cellular/Mobile number: FedEx account number to be charged for transportation charges: My name and direct phone number (ext): My email address (to receive confirmation of booking #): I agree that the determination of the final chargeable weight of the shipment will be made by FedEx. The shipper (or the person who pays for transportation charges) is responsible for paying the chargeable weight. If acct# of payor is not valid at time of billing all transportation charges will be billed to my FedEx acct#. Send Signature: Company Stamp: