800.343.1196

Create Inbound Shipment

If you are a first time customer and are ready to ship, please fill out Open Account Form and then come back to this shipment form.

If you are an existing customer please fill out the form below or Download Shipment Form. Glines & Rhodes, Inc. will be in contact with you within one business day to verify your new account information and help facilitate shipment if needed.   

Need shipping containers?  Contact Us or populate designated fields below. Click here to see options.

 
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Company Name*
Ship Date
First name*
Last name*
 Date Recieved (for Internal Use): __________________________
Address 1
Address 2
Customer Refence Number
City
State*
First time customer
Zip
Country*
Other Country
Fax
Email*
  
Telephone
Cell Phone
  
      WEIGHTS:
Please designate units
Troy Ounces (T.O.), Pennyweights (DWT), Grams, or LBS
# OF PACKAGES PACKAGE TYPE MATERIAL AND CONTENT DESCRIPTION GROSS WEIGHT TARE WEIGHT NET WEIGHT
Item 1 # of Packages
Item 1 Package Type
Item 1 Material & Content Description
Item 1 Gross Weight
Item 1 Tare Weight
Item 1 Net Weight
Item 2 # of Packages
Item 2 Package Tye
Item 2 Material & Content Description
Item 2 Gross Weight
Item 2 Tare Weight
Item 2 Net Weight
Item 3 # of Packages
Item 3 Package Type
Item 3 Material and Content Description
Item 3 Gross Weight
Item 3 Tare Weight
Item 3 Net Weight
Item 4 # of Packages
Item 4 Package Type
Item 4 Material & Content Description
Item 4 Gross Weight
Item 4 Tare Weight
Item 4 Net Weight

Assay For:

Assay
Gold
Silver
Platinum
Palladium
Iridium
Ruthenium
Rhodium
Other, list here:

Settlement Options:

Settlement Options
Check
Wire
Hold in Toll
Grain
Bullion
Transfer to Supplier (Please list Supplier):

Need shipping containers? 

Need Shipping Containers?
No thank you.
Yes, I need prior to this shipment.
Yes, I need after this shipment.

  Container Type Units
55 gallon metal drum
55 gallon metal drum
55 gallon fiber drum
55 gallon fiber drum
30 gallon plastic drum rated by the DOT to transport various solutions
30 gallon plastic drum
12 gallon fiber drum
12 gallon fiber drum
5 gallon metal pail
5 gallon metal pail
3 gallon metal pail
3 gallon metal pail
64 ounce jar
64 ounce jar
32 ounce jar
32 ounce jar
16 ounce jar
16 ounce jar
Special Instructions and Notes:

Digitally Sign Below:

Customer Signature

G&R Signature:

 

 

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G&R Rep Name Print:

 

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