I will be responsible for all charges occurred due to my request (i.e. destroy surcharge, duty/tax if any or in case of
payment refused by recipient, re-route surcharge, return freight charge) by allowing FedEx or its concerned affiliates to
charge:
□ My FedEx account number: _______________________________________________________________________
□ Credit card (Visa/MasterCard or AMEX) __________________________________________Expiry Date: ____/____
Please process per my request. With hereby signature, I fully understand that the service requested is auxiliary
and not guaranteed.