Courier Service Request Form Questions
Let us know how we can help you!
SECTION 1: CLIENT INFORMATION
Full Name
First Name
Last Name
Company Name (If Applicable)
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Preferred Method of Communication
Please Select
Call
Text
Email
Is this a one-time delivery or recurring service?
Please Select
One-Time
Weekly
Monthly
On-Demand Contract
Not Sure yet
SECTION 2: Delivery Details
Type of Delivery Needed
Please Select
Standard delivery
Same-Day Delivery
Rush/ASAP Delivery
Legal/Court Documents
Medical Courier
Real Estate Documents
Smll Package Delivery
Other
(1)Pickup address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(2)Delivery Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Additional Stops Needed?
Please Select
Yes (if yes, add additional address below)
No
Request Pickup Date
-
Month
-
Day
Year
Date
Request Pickup Time Window
Please Select
ASAP (within 2 hours, Fee applies)
Same Day
Scheduled (enter time)
Schedule Pickup Time Request
Hour Minutes
AM
PM
AM/PM Option
Delivery Deadline
Please Select
No Rush
Same Day
Before specific time (enter time)
Requested Delivery Deadline or Time Window
Contact person at pickup:
Special Pickup Instructions:
Upload Documents or Delivery Instructions (Optional)Description: Uploading files is optional, but it helps us provide faster scheduling, accurate pricing, and prepare for your delivery efficiently.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
SECTION 3: PACKAGE INFORMATION
Other (describe)
Is the item confidential?
Please Select
Yes
No
Estimated Weight
Please Select
Under 5 lbs
5-20 lbs
20-50 lbs
Over 50 lbs
Dimensions (if known)
Does the item require:
Please Select
Photo Confirmation
Temperature control
Fragile handling
Chain of Custody Documentation
ID Verification upon delivery
Return Delivery
None
SECTION 4: SECURITY & LIABILITY
Declared Value of Contents
Are contents insured?
Please Select
Yes
No
Information will be provided
Any hazardous materials?
Please Select
Yes
No
(if Yes-Describe)
Describe
Do you also need any of the following services?
Please Select
Printing
Scanning
Notary Services
Apostille Assistance
Witnesses
Remote Online Notary
Document Drop-Off/Filing
SECTION 4: Scheduling & Notes
Is this a recurring delivery or route?
Please Select
One-Time Delivery
Weekly
Daily
Ongoing Business Route
SECTION 5: PAYMENT
Preferred Payment Method
Please Select
Zelle
ACH
Business Invoice
Credit Card
Cash (approved clients only)
Email
example@example.com
Billing Address (if different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
SECTION 6: AGREEMENT
I understand that submitting this form is a request for service and not a guaranteed appointment until confirmed by Sunshine State Notary / Via Lainez Express.
Please Select
Yes
No
Submit
Should be Empty: