Account No. – If you have a customer account with M Xpress, please fill in your account number (pre-printed by M Xpress)

1. Print your name, address, postal code, and phone number
2. Print the receiver’s name, address, postal code and phone number
3. Sender’s Authorisation and Signature with date
4. Indicate services required and nature of shipment
   1. Types of Services – Please state if applicable
   2. Item – Indicate number of item
   3. Actual Weight – Weight in Kilograms
   4. Measurement – Dimension in Centimeters (Height x Length x Width)
   5. Volumetric Weight – Weight in Kilograms (Result of Calculation for Dimensions/ 5000)
   6. Seal Ref. – Indicate if there is a seal number
5. DO Reference
6. Completed by M Xpress at the time of pick up.
7. Additional Remarks – if there is any other additional information provide
8. Receiver’s Received Acknowledgement – Receiver to complete Receiver’s name, date receive and NRIC/ company stamp
9. Settlement (RM) – Completed by M Xpress