 1a. U.S. PRINCIPAL PARTY IN INTEREST |
5. FORWARDING AGENT |
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2. DATE OF
EXPORTATION |
3. TRANSPORTATION
REF. |
6.
STATE OF ORIGIN |
7.
COUNTRY OF ULTIMATE DESTINATION |
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4a. ULTIMATE CONSIGNEE (Complete name & address) |
8.
LOADING PIER (Vessel) |
9.
METHOD OF TRANSPORT |
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10. EXPORT VESSEL NAME |
11. PORT OF EXPORT |
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12
PORT OF UNLOADING |
13. CONTAINERIZED |
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4b. ULTIMATE CONSIGNEE (Complete name & address) |
14. CARRIER |
15. PARTIES TO TRANSACTION. |
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16. ENTRY NUMBER |
17. HAZARDOUS MATERIAL |
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18. IN BOND CODE |
19. ROUTED EXPORT TRANS. |
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20. SCHEDULE B DESCRIPTION OF COMMODITIES (21 THRU 24) |
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FULL COMMERCIAL
DESCRIPTION 1:
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FULL COMMERCIAL DESCRIPTION 2:
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FULL COMMERCIAL DESCRIPTION 3:
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FULL COMMERCIAL DESCRIPTION 4:
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FULL COMMERCIAL DESCRIPTION 5:
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D/F OR M |
SCHEDULE B NUMBER
[ LOOK-UP NO ] |
QUANTITY - SCHEDULE B UNIT(S)
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SHIPPING WEIGHT (Kilograms ONLY) |
VIN / PRODUCT NUMBER / VEHICLE TITLE NO.
(Used only for used vehicles) |
VALUE in
U.S. Dollars ONLY |
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21 |
22 |
23 |
24 |
25 |
26 |
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KGS |
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US$
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KGS |
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US$
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KGS |
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US$
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KGS |
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US$
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KGS |
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US$
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27. LICENSE NO.: |
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28. EECN (When
required): |
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Requested by: |
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Please sign by stating
your E-mail address! |
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