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UNIFORM STRAIGHT BILL OF LADING - Domestic Document No. 15 Your Source Company Shipper s No. 147898 Your Source for Everything You Need Carrier s No. 8796801 123 Main St. Date 05/05/2010 Anytown, USA 12345 Federal Express (Name of Carrier) Route: Vehicle Number: No. Shipping units Kinds of Packaging, Description of Articles, Special Marks and Exceptions Weight (Subject to Correction ) Rate Charges (for Carrier use only) 1 Box, stuff 15 lbs. 1.14 REMIT COD C.O.D. FEE: $N/A C.O.D. TO: N/A Amt: $ 0,00 PREPAID □ ADDRESS COLLECT □ Note - Where the rate is dependent on value, shippers are required to state specifically in writing the agreed or declared value of the property. Subject to Section 7 of the condition, if this shipment is to be delivered to the consignee without recourse on the consignor, the consignor shall sign the following statement; Total Charges $ 17.10 The agreed or declared value of the property is hereby specifically stated by the shipper to be not exceeding. The carrier shall not make delivery of this shipment without payment of freight and all other lawful charges. FREIGHT CHARGES $ 1,200.00 per box (Signature of Consignor) Check Appropriate Box: □ Freight prepaid □ Bill to shipper □ Collect

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