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<title>Windsor Distribution Proof of Delivery Request</title>
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<p align="center"><b><i><font SIZE="+2">PROOF OF DELIVERY REQUEST</font></i></b></p>
<p align="center"><strong>Please provide the following information so that we may complete
your request for a proof of delivery.</strong></p>
<form method="POST" action="_vti_bin/shtml.dll/Proof.htm" webbot-action="--WEBBOT-SELF--">
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<tr ALIGN="center">
<td WIDTH="100%" HEIGHT="29" colspan="2"><div align="center"><center><p> <b>SHIPPER
INFORMATION:</b></td>
</tr>
<tr align="center">
<td WIDTH="32%" HEIGHT="29" align="center"><strong>Name</strong></td>
<td WIDTH="68%" HEIGHT="29" align="center"><div align="center"><center><p><input
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<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="38"> <strong>Company Name</strong></td>
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<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="38"> <strong>Phone Number</strong></td>
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<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="29"> <strong>Fax Number</strong></td>
<td WIDTH="68%" HEIGHT="29"><input NAME="FAX" TYPE="text" SIZE="35"> </td>
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<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="38"> <strong>E-mail Address</strong></td>
<td WIDTH="68%" HEIGHT="38"><input NAME="EMAIL" TYPE="text" SIZE="35"> </td>
</tr>
<tr ALIGN="center">
<td COLSPAN="2" HEIGHT="19"><div align="center"><center><p><b> CONSIGNEE INFORMATION:</b></td>
</tr>
<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="29"> <strong>Name</strong></td>
<td WIDTH="68%" HEIGHT="29"><input NAME="CONNAME" TYPE="text" SIZE="35"> </td>
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<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="29"> <strong>Address</strong></td>
<td WIDTH="68%" HEIGHT="29"><input NAME="CONADDRESS" TYPE="text" SIZE="35"> </td>
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<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="29"> <strong>City</strong></td>
<td WIDTH="68%" HEIGHT="29"><input NAME="CONCITY" TYPE="text" SIZE="35"> </td>
</tr>
<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="29"> <strong>State</strong></td>
<td WIDTH="68%" HEIGHT="29"><input NAME="CONSTATE" TYPE="text" SIZE="35"> </td>
</tr>
<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="29"> <strong>Zip</strong></td>
<td WIDTH="68%" HEIGHT="29"><input NAME="CONZIP" TYPE="text" SIZE="35"> </td>
</tr>
<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="29"> <strong>Ship Date</strong></td>
<td WIDTH="68%" HEIGHT="29"><input NAME="DATE" TYPE="text" SIZE="35"> </td>
</tr>
<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="38"> <strong>Order Number</strong></td>
<td WIDTH="68%" HEIGHT="38"><input NAME="ORDER" TYPE="text" SIZE="35"> </td>
</tr>
<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="38"> <strong>Number of Pieces</strong></td>
<td WIDTH="68%" HEIGHT="38"><input NAME="PIECES" TYPE="text" SIZE="35"> </td>
</tr>
<tr ALIGN="center">
<td WIDTH="32%" HEIGHT="29"> <strong>Weight</strong></td>
<td WIDTH="68%" HEIGHT="29"><input NAME="WEIGHT" TYPE="text" SIZE="35"> </td>
</tr>
<tr ALIGN="center">
<td COLSPAN="2" HEIGHT="19"><div align="center"><center><p><b>OTHER COMMENTS:</b></td>
</tr>
<tr ALIGN="center">
<td COLSPAN="2" height="1"><div align="center"><center><p> <textarea
NAME="COMMENTS" ROWS="5" COLS="47"></textarea></p>
</center></div><div align="center"><center><p><input type="submit" value="SUBMIT REQUEST"
name="B1"><input type="reset" value="CLEAR FORM" name="B2"></td>
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</table>
<div align="center"><center><p> </p>
</center></div><div align="center"><center><p> </p>
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