INFLATABLE DEVICE SERVICE RETURN FORM
(Print and fill out this form and send it with your equipment)

SHIPPING INFORMATION

Name:________________________________________________________________________

Street Address:_________________________________________________________________
(no PO Boxes)

Residential Address?                YES                   NO

City, State, Zip:________________________________________________________________

Daytime Phone:_________________________________________________________________

Email:_________________________________________________________________________

Brand of equipment:_____________________________________________________________

Vessel Name:___________________________________________________________________

BILLING INFORMATION

If you wish to provide credit card information please fill out the following section, otherwise we will call you regarding payment:
(We accept Visa/MasterCard)

Name on the card:_______________________________________________________________

Card Number:__________________________________________________________________

Expiry Date:_____________ V Code:_______________________________________________
(V Code is the last 3 digits on the signature strip for Visa/MC)

Billing Address for the Card:_______________________________________________________

_____________________________________________________________________________

Signature:______________________________________________________________________

Ship to:
Westpac Marine Services, Inc.
2316 South Jefferson Ave.
Tacoma, WA 98402

MOM-8 & MOM-9: Effective 1/1/05 the MOM-8 and MOM-9 are no longer considered hazardous material for shipping by ground. This means you can ship them by UPS or FedEx ground providing it is packed in a fiberboard box with a minimum burst strength of 275# or 44# edge crush test. These units may NOT be shipped by the US Postal Service. Failure to follow our shipping instructions will result in a $100.00 penalty.

Inflatable life rafts are HAZARDOUS MATERIAL for shipping. The proper shipping information is:
    LIFE SAVING APPLIANCES, SELF INFLATING, 9, UN2990
    The hazard weight is the same as the shipment weight.
    Pack in a fiberboard box with a minimum burst strength of 275# or 44# edge crush test.
United Parcel Service and FedEx Ground will only accept them from known, trained shippers. Shipment by air is considerably more difficult. We suggest you use Yellow Freight Lines (800) 610-6500. Read the information here or call us at (800) 343-5826 if you have any questions or need help.

revised 8/03