DUNNAGE RETURN REQUEST FORM

DUNNAGE RETURN REQUEST FORM
INSTRUCTIONS
YesNo
IF YOU CHECKED YES, PLEASE COMPLETE THIS FORM FOR SUBMITTAL.

IF YOU CHECKED NO, OR YOU ARE UNSURE IF THE DUNNAGE IS PREPARED CORRECTLY, REFERENCE THE DUNNAGE AGREEMENT FOR FURTHER INSTRUCTIONS
CUSTOMER INFORMATION
Date

MonthDayYear
Date
Company
Shipping Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Billing Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TOTAL DUNNAGE QUANTITIES
Ardagh Plastic Pallets (57 lbs each)
CanPack Plastic Pallets (57 lbs each)
Ardagh Plastic Frames (11 lbs each)
CanPack Plastic Frames (11 lbs each)
Ardagh Plastic Slip Sheets (2 lbs each)
CanPack Plastic Slip Sheets (2 lbs each)
Customer Arranged Freight

Complete if arranging your own dunnage freight
Carrier Name
Pro Number
Estimated Arrival Date

MonthDayYear
Date
Lagersmith - MN1, 2077 Ellis Avenue, Door 27, Saint Paul, MN 55114Lagersmith - OH1, 870 Graham Drive, Fremont, OH 43420
Lagersmith Arranged Freight

Complete if you need Lagersmith to arrange dunnage freight. Please be precise in providing the construct of each stack of dunnage to accurately calculate freight for your return. You must click, Add Stack, to provide the configuration of each stack of dunnage you are returning.
Stack Configurations
YesNo
Limited AccessSchedule AppointmentLift GatePick Up Notification
Should be Empty:

INSTRUCTIONS