Becoming a Known Shipper

Please take a moment to complete this agreement and mail it to us. Becoming a Known Shipper is Federally Mandated for Homeland Security purposes. Thank You.

PREFERRED CUSTOMER RECORD AND SHIPPING AGREEMENT

Transportation Security Administration (TSA) security procedures require that you complete this Shipping Agreement and Security Endorsement, which will qualify you as a Preferred Shipper. Becoming a Preferred Shipper will Streamline the pick-up and delivery of your package and speed you through the ordering and billing process.

Completing this document is easy. Simply complete the information below, sign in the space provided, fax the completed agreement to 800-795-9USA, and mail the original immediately to:

USA Couriers, Inc
Attention: TSA Security Procedures
31 State Street, 8th Floor
Boston, MA 02109

Please note that we cannot qualify you as Preferred (Known) Shipper until we have have your original signed Agreement and credit application on file and have completed your set up process. In the meanwhile, you may still be able to arrange shipments with USA Couriers, but applicable TSA and airline-specific regulations may restrict the itineraries available to you and additional information and identification will be required at the time of package pick up.

In addition, “I certify that this cargo does not contain unauthorized explosives, incendiaries, or other destructive substance or items. I am aware that this endorsement and original signature and other shipping documents will be retained on file for a minimum of 30 calendar days. I also agree to have this shipments and any future cargo screened by trained and authorized cargo screeners.”

Privacy Act Notice

“49 USA 114 authorizes the collection of this information. The information you provide will be used to qualify you or verify your status as a possible “known shipper”. Providing this information is voluntary, however, failure to provide the information will prevent you from qualifying as a “known shipper”. This information is disclosed to the TSA personnel and contractors or other agents including IACs in the maintenance and operation of the known shipper program. TSA may share the information with airport operators, foreign air carriers, IACs, law enforcement agencies, and others in accordance with the Privacy Act, 5 USC Section 552a. For additional details, see the system of records notice for Transportation Security Threat Assessment System (DHS/TSA 002) published in the Federal Register.”

 

REQUIRED INFORMATION SHIPPER INFORMATION
Company Name
Contact
Street Address
City
State
Zip
Telephone
Fax
E-mail Address
D&B (if avail)
SIC Code#
Tax ID#
SIGNATURE
  Please PRINT this form and follow the above instructions.