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Contact Name*:
Name of Forwarder*:
Email Address*:
Phone Number:
Fax Number:
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Name of Forwarder:
Contact Name:
Phone Number:
Fax Number:
Email Address:
Date Goods Given to Forwarder:
COURIER (Please advise courier information if we do not have it on file):
Name of Courier Company:
Courier Account Number:
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