From the office of
Robert Pearlmann
Robert N. Pearlman, President


Shipper Name

Account

Moved From: City/State

Moved To: City/State



1. Was the communication with Nationwide adequate and helpful?
     Yes      No

2. Were the packers, driver and helpers in uniform?
     Yes      No

3. Did your shipment load as agreed?
     Yes      No

4. Did your shipment deliver as agreed?
     Yes      No

5. Do you have a claim for loss or damage?
     Yes      No (If yes, please explain):

6. Overall, how satisfied were you with Nationwide?
     Excellent      Good      Fair      Poor

7. Overall, how satisfied were you with North American?
     Excellent      Good      Fair      Poor

8. Would you use the same company again?
     Yes      No
    Comments:



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