[ ] NOTIFICATION OF CHANGE FORM

[ ] NEW BOX

[ ] CLOSED BOX

Customer / Company Name:
# POS	[ ] E Zone a/c   [ ] P O Box a/c
Home #
Office #	Ext # Fax #:
Mobile #
E-mail address :
Current Delivery Address:
Details of Change / New  Information:
Reason for Change:

Print Name:	Signature:
Date:

THIS FORM IS TO BE CIRCULATED TO ALL DEPARTMENTS AND TO RESPECTIVE COURIER(S) (as required)!

Cc:	1. Customer Service Department 2. Finance Department 3. Operations Department 4. Existing Courier 5. New Courier