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Get Deringer Combination Invoice-Declaration by Foreign Shipper

S BUYER — ADDRESS ADDRESS IRS# PAGE OF PAGES OF IRS# BILL U.S. DUTY, MPF, AND/OR BROKERAGE TO: ACCOUNT NUMBER: អ CONSIGNEE អ BUYER PORT OF ENTRY អ SHIPPER U.S. DUTY AND BROKERAGE INCLUDED IN INVOICE VALUE: PLACE OF LADING (CITY/PROVINCE) អ YES អ NO TERMS OF SALE, PAYMENT, AND DISCOUNT អ PLANT F.O.B. LOCAL CARRIER BILL OF LADING #: EXPORTING CARRIER IS FREIGHT INCLUDED IN INVOICE VALUE? អ NO អ YES AMOUNT អ DESTINATION, OR DERINGER TO PROVIDE CARGO INSURANCE.

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