SHIPPER'S LETTER OF INSTRUCTION
1a. USPPI (Name and address including ZIP Code)
2. FREIGHT CHARGES
PREPAID
COLLECT
3. INCOTERMS 2000
5777 W. Century Blvd., Suite 1040
EXW
CIP
Los Angeles, CA 90045 USA
FCA
DAF
2299 Kenmore Ave.
1b. USPPI EIN (IRS) NO.
1c. ZIP CODE
FAS
DES
FOB
DEQ
Buffalo, NY 14207
CFR
DDU
1d. PARTIES TO TRANSACTION
(800) 447-3033
RELATED
NON-RELATED
CIF
DDP
CPT
4a. ULTIMATE CONSIGNEE
$0.00
5. DECLARED VALUE FOR CARRIAGE
NO
YES
6. ROUTED EXPORT TRANSACTION?
7. SHIPPER REQUESTS INSURANCE
YES
NO
$0.00
OTHER AMOUNT:
CIF PLUS 10%
4b. INTERMEDIATE CONSIGNEE
8. POINT (STATE) OF ORIGIN
9. COUNTRY OF ULTIMATE DESTINATION
10. TYPE OF SERVICE
AIR
OCEAN
OTHER (specify):
11. SHIPPER'S INSTRUCTIONS IN CASE OF INABILITY TO DELIVER CONSIGNMENT
AS CONSIGNED
RETURN TO SHIPPER
12. FORWARDING AGENT
Speed Global Services
ABANDON
)
13. SCHEDULE B DESCRIPTION OF COMMODITIES
VALUE
20. SHIPPER'S REF. NO.
)
14. MARKS, NOS., AND KINDS OF PACKAGES
(U.S. dollars, omit cents)
(Use column 14-18)
SHIPPING
(Selling price or cost if not
D/F
D/F
SCHEDULE B NUMBER
SCHEDULE B NUMBER
QUANTITY -
QUANTITY
21. CONSIGNEE'S REF. NO.
21. CONSIGNEE S REF. NO.
WEIGHT (Kil
WEIGHT (Kilos)
)
sold)
ld)
SCHEDULE B UNIT(S)
(17)
(15)
(16)
(18)
(19)
$0.00
22. DOCUMENTS
ATTACHED / PREPARE
COMMERCIAL INVOICE
PROFORMA INVOICE
CONSULAR INVOICE
EXPORT LICENSE
PACKING LIST
CERTIFICATE OF ORIGIN
INSURANCE CERTIFICATE
LETTER OF CREDIT
BANK SIGHT DRAFT
OTHER (specify below):
23. VALIDATED LICENSE NO./GENERAL LICENSE SYMBOL
24.ECCN (When required)
25. IS THIS A SHIPMENT OF HAZARDOUS MATERIALS?
NO
YES
26. Duly authorized officer or employee signature
27. SPECIAL INSTRUCTIONS (Include Hazmat information if applicable):
The USPPI authorizes the forwarder named above to act as
forwarding agent for export control and customs purposes.
I certify that all statements made and all information contained herein are true and correct and that I have read and
understand the instructions for preparation of this document, set forth in the "Correct Way to Fill Out the Shipper's Letter of
Instructions." I understand that civil and criminal penalties, including forfeiture and sale, may be imposed for making false
or fraudulent statements herein, failing to provide the requested information or for violation of U.S. laws on exportation (13
U.S.C. Sec. 305; 22 U.S.C. Sec. 401; 18 U.S.C. Sec. 1001; 50 U.S.C. App. 2410).
28a. Signature
29. WE HAVE FORWARDED TO YOU, THE SHIPMENT DESCRIBED ABOVE VIA:
Export shipments are subject to inspection by U.S.
YOUR TRUCK
OTHER CARRIER
Customs Service and/or Office of Export
Enforcement and/or Amber Freight Shipping Lines.
28b. Name (please type or print)
CARRIER NAME:
DRIVER SIGNATURE:
28c. Title
30. Date
DATE:
TIME:
TIME: