Contact Information
Business Name:
Contact Name: (REQUIRED)
Email Address: (REQUIRED)
Phone Number:
Fax Number:
Location (City, State, Country):

Have you previously imported goods into the United States?		Yes No
	If Yes,  Importer of Record name:
	If Yes,  Importer's Tax ID Number:

Name of the Party Responsible for Payment of...
	Freight Charges:
	Customs Clearance:

Information about the Cargo
Commodity: (REQUIRED)
Harmonized Tariff Code (if known):
Hazardous Goods?	Yes No
Terms of Sale of Goods:
Value of the Cargo (for Customs & Insurance):
Country of Origin of Goods:

Packaging Information
Number of Pieces:
Packaging Type (Bags, Cartons, Pallets, Etc.):
Total Weight:	Kgs Pounds
Dimensions (LxWxH):

Transportation Details
Pickup Point (City, State, Country): (REQUIRED)
Pickup Postal Code:
Delivery Point (City, State, Country): (REQUIRED)
Delivery Postal Code:
Cargo Availability Date (MM/DD/YY):
Delivery Deadline (MM/DD/YY):
Time Critical Shipment?	Yes No
Preferred Transport Mode:	Don't Know Air Ocean Rail Truck

NOTE: All freight quotes are based on accurate weights & dimensions, and proper export packaging or crating. If any package is overweight or oversized, improperly packaged, or contains Hazardous Materials additional charges might be incurred.