Contact Name*:


Name of Forwarder*:


Email Address*:


Phone Number:


Fax Number:


Port of Departure:


Port of Destination:


Vessel Name:


Voyage Number:


Tentative On Board Date:


Select Reference:
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* Please Advise The Following Information *

Name of the Ocean Carrier (if we cannot show yourself “as carrier”):

Pieces/Weight:


Type of Packaging (cartons, skids, crates, etc.):


Size/type of container(s) (if applicable):


Container Number(s) and Seal Number(s) (if applicable):


Enter additional container/seal numbers, if applicable, in the "Special Instructions/ Notes:" area of this worksheet.