Please fill out the form below to request a Pick-Up with Dependable Highway Express. We will get back to you as soon as possible. Thank you!

All Pick-Up requests must be submitted by 4:30 pm for same-day Pick-Up. Thank you for your cooperation!

For our days of operation, please click here.

Fields marked with (*) are required to process the request.

All dates in (mm/dd/yyyy) format and all times in (hh:mm) AM/PM format.

Customer Information
Customer Code
Company Name	*
Address
City
State		Alabama Alaska Arizona Arkansas California Canal Zone Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
Zip Code
Pick-Up Location Information
Company Name	*
Pick-Up Date	*	(mm/dd/yyyy)
Pick-Up Address	*
Pick-Up State	*	Alabama Alaska Arizona Arkansas California Canal Zone Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
Pick-Up City	*
Pick-Up Zip Code	*
Phone	*	(123-456-7890)
Contact Name	*
Email Address	*
Hours of Operation
Closing Time	*	(hh:mm am/pm)
Ready Time	*	(hh:mm am/pm)
Ready Now		No Yes
For DDC		No Yes
Freight Information (Please only enter numeric data for Cartons, Pallets and Weight fields.)
Item # Cartons Pallets Weight Destination City Destination Zip Code  1 *   2  3  4  5  6  7  8  9  10
Comments (Max. 100 characters)