UPS Return Service Receipt

## Return Service Receipt **THIS IS NOT A SHIPPING LABEL. PLEASE SAVE FOR YOUR RECORDS.** ### Process Information - **Process Date:** FRI 21 MAR 2025 - **Expected Transit Time:** 1 BUS. DAY - ESTIMATE ONLY - **Processed By:** THE UPS STORE #3146, SAINT PETERSBURG, FL 33704-1416, (727) 822-5823 ### Delivery Information - **Deliver To:** JOHAN JONGSMA - **Address:** 851 BRIGHTWATERS BLVD NE, SAINT PETERSBUR FL 33704-3719 - **Phone:** (727) 225-2475 ### Pickup Information - **Pickup From:** PURE COMPANY PHARMACY - **Address:** 603 E DIEHL RD, STE 131, NAPERVILLE IL 60563-4907 - **Type:** RESIDENTIAL ### Shipment Information - **Service:** UPS NEXT DAY AIR EARLY RES - **Weight:** 4 lb 0.0 oz manual wt / 4.000 lb billable wt - **Dimensions:** 10.00X8.00X6.00 IN - **Label Type:** RETURN SERVICE RETURN LABEL - **Email Notification:** SHIP - **Tracking Number:** 1ZE03E62U126148165 - **Shipment ID:** MHUMNUUP6HSCJ - **Ship Ref 1:** - - - **Ship Ref 2:** - - ### Description of Goods - **Contents:** MEDICATION - 2 BOTTLES ### Shipment Charges | Item | Amount | |------|--------| | NEXT DAY AIR EARLY RES | 151.63 | | SERVICE OPTIONS | 2.10 | | FUEL SURCHARGE | 26.52 | | CMS PROCESSING FEE | 0.22 | | **TOTAL** | **$180.47** | ### Tracking & Support - **Complete Online Tracking:** HTTP://THEUPSSTORE.COM (Select Tracking, enter Shipment ID #) - **Questions:** Contact shipped through above - **Package Help (Lost/Damaged):** HTTPS://ONLINE.UPSCAPITAL.COM/TCCP --- **SHIPMENT ID:** MHUMNUUP6HSCJ **Timestamp:** 03/21/2025 04:45 PM Pacific Time F **Powered by:** Ship(r) *The UPS Store* SEE NOTICE ON REVERSE regarding UPS Terms, and notice of limitation of liability. Where allowed by law, shipper authorizes UPS to act as forwarding agent for export control customs purposes. If exported from the US, shipper certifies that the commodities, technology or software were exported from the US in accordance with the Export Administration Regulations. Diversion contrary to law is prohibited.