
Shipment Release Authorization
By my signature, I am requesting that FedEx leave the shipment at the location indicated above. I release FedEx from all liability for any loss
or damage that may result from leaving this shipment at my request.
Print Name (First and Last Name): __________________________________________________
Recipient's Signature: ________________________________________ Date: _______________
Customer Instructions Additional Information
1. Print this page and use this form if you will not be home on
the day of your expected delivery.
2. Please mark your preferred delivery location and sign below.
Your package cannot be delivered without a valid signature.
3. Affix to your front door before 8:00am on the day of your
expected delivery.
Note: A separate Release Authorization form is required for
each package.
FedEx will not deliver the package unless this Release
Authorization is present for the driver to collect when the delivery
is attempted. If a neighbor's address is indicated below, someone
at the address must sign for the package. FedEx will not deliver the
package to an address other than the address on the package
without obtaining a live signature. All deliveries are subject to
driver's discretion for safety and security reasons.
Visit
fedex.com to track your shipment.
I authorize FedEx to leave the following referenced package: At the following designated place:
Tracking Number:
732792966128
Recipient Name:
James M Henry
Recipient Address:
James M Henry
310 dawn st
signal mountain, TN 37377
Zip:
37377
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Front door Back door
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Other ___________________
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Immediate Neighbor or Building Manager
Address ____________________________
(Your neighbor or building manager must be present to sign for
the package. Provide address above.)
FedEx use only
Zip: Delivery Date: