FROM (Full address & area code)
Name:

Address:

State:

Area code:

Country:

Telephone:

Ctc:

E-mail:

Shipment required from:

Location:

FROM:

Door	EXW
Depot / Terminal	FCA
Wharf/Airport	FOB/FOA

Description of Goods:

TO (Full address & area code)
Name:

Address:

State:

Area code:

Country:

Telephone:

Ctc:

E-mail:

Shipment required to:

Location:

TO:

Door	DDU/DDP
Depot / Terminal	CPT
Wharf/Airport	CIF/CFR

Type of Packages

Hazardous

Haz Class

 UN No:

Refrigerated

Temp required

Gross Weight: (kg)

General Cargo

Overwidth

Overheight

Overlength

Expected date ready to ship:

Date required at destination:

Shipment value:

Method of Payment:

Telegraphic Transfer Bank Draft Letter of Credit Open Account

Value Currency:

Insurance Required?