SHIP TO: |
| Company name: |
Airway Bill No:
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| Company Address: |
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SHIPPED VIA: ICR Worldwide Express LTD |
| No. of pieces: |
Shipment Date:
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| Contact Name: |
Phone No:
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Sender's VAT No:
EORI No: |
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Reason for Export: |
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| Country of Origin: |
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Terms of Delivery: |
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I declare that the above information is true and correct to the best of my knowledge and that the goods are of
origin. |
Signed, for and on behalf of the Company. |
| Name: |
Position in Company:
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Signature:
(sign in pen after printing) |
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| Date: |
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