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Get Shipper's Letter of Instruction 2011-2024

Print Form 1a. EXPORTER Name and address including ZIP CODE SHIPPER S LETTER OF INSTRUCTIONS b. EXPORTER S EIN IRS NO. c* PARTIES TO TRANSACTION Related Unrelated 4a* ULTIMATE CONSIGNEE 3. BILL OF LADING/ AIR WAYBILL NO. 2. DATE OF EXPORT SHIPPER S REFERENCE b. INTERMEDIATE CONSIGNEE 5. FORWARDING AGENT 6. POINT STATE OF ORIGIN OR FTZ NO. 8. LOADING PIER Vessel only Specify 9. MODE OF TRANSPORT 7. COUNTRY OF ULTIMATE DESTINATION SHIPPER MUST CHECK 12. PORT OF UNLOADING PREPAID Vessel and air only 13. CONTAINERIZED Yes No SCHEDULE B DESCRIPTION OF COMMODITIES CONSOLIDATE GROUND RETURN TO SHIPPER AMOUNT OCEAN SHIPPER S INSTRUCTIONS IN CASE OF INABILITY TO DELIVER AS CONSIGNED 14. SHIPPER REQUESTS INSURANCE DIRECT COD 11. PORT OF EXPORT AIR COLLECT 10. EXPORTING CARRIER Use Columns 17-19 SHIPPER S NOTE 15. MARKS AND NOS* AND KINDS OF PACKAGES D/F SCHEDULE B NUMBER ABANDON DELIVER TO CHECK DIGIT QUANTITY SCHEDULE B UNITS SHIPPING WEIGHT Kilos VALU E U*S* dollars IF YOU ARE UNCERTAIN OF THE SCHEDULE B COMMODITY NO. DO NOT TYPE IT IN - WE WILL COMPLETE WHEN PROCESSING* omit cents Selling price or cost if not sold WE HAVE FORWARDED TO YOU THE SHIPMENT DESCRIBED BELOW VIA YOUR TRUCK OTHER CARRIER LISTED BELOW TRUCK LINE NAME RECEIPT PRO NUMBER 21. VALIDATED LICENSE NO. /GENERAL LICENSE SYMBOL 22. ECCN When required 23. Duly authorized officer or employee The exporter authorizes the forwarder named above to act as forwarding agent for export control and customs purposes. 24. I certify that all statements made and all information contained herein are true and correct and that I have read and understand the instructions for preparation of this document set forth in the Correct Way to Fill Out the Shipper s Export Declaration* I understand that civil and criminal penalties including forfeiture and sale may be imposed for making false or fraudulent statements herein failing to provide the requested information or for violation of U*S* laws on exportation 13 U*S*C. Sec* 305 22 U*S*C. Sec* 401 18 U*S*C. Sec* 1001 50 U*S*C. App* 2410. Signature Title Confidential - For use solely for official purposes authorized by the Secretary of Commerce 13 U*S*C. 301 g. Export Shipments are subject to inspection by U* S* Customs Service and/or Office of Export Enforcement. PLEASE SIGN THE FIRST EXPORT DECLARATION IN BOX 23 WITH PEN AND INK DOCUMENTS ENCLOSED SPECIAL INSTRUCTIONS Date NOTE The Shipper or his authorized agent hereby authorizes the above named Company in his name and on his behalf to prepare any export documents to sign and accept any documents relating to said shipment and forward this shipment in accordance with the conditions of carriage and the tariffs of the carriers employed* The shipper guarantees payment of all collect charges in the event the consigned refuses payment. Hereunder the sole responsibility of the Company is to use reasonable care in the selection of carriers forwarders agents and others to whom it may entrust the shipment. c* PARTIES TO TRANSACTION Related Unrelated 4a* ULTIMATE CONSIGNEE 3. BILL OF LADING/ AIR WAYBILL NO. 2. DATE OF EXPORT SHIPPER S REFERENCE b. INTERMEDIATE CONSIGNEE 5. FORWARDING AGENT 6. POINT STATE OF ORIGIN OR FTZ NO. .

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