Shippers Letter Of Instruction

Shipper's Name: Quote Ref No:
Shipper's Address: Postcode:
Consignee's Name: Notify Party:
Consignee's Address:
Contact: Contact:
Phone: Phone:
Insurance Required: Amount of Insurance: $
Shipper's Reference:
FOB/FAA Value for Customs:
Method of Transport:
Port of Departure:
Invoice Value: $
Terms of Sale:
Purpose of Export: Other:
Freight Charges:
Cartage Required:
Copy Letter of Credit Supplied:
Copy Letter of Credit Supplied: Despatch to:
No. of Pieces
Dimensions (cm)
L x W x H
Nature and Quantity of Goods
DANGEROUS GOODS - Does this consignment consist of any hazardous or dangerous goods?
It is agreed that the goods herein are accepted in apparent good order and condition subject to the conditions of carriage (following). THE SHIPPER'S ATTENTION IS DRAWN TO THE NOTICE CONCERNING CARRIER'S LIMITATION OF LIABILITY. Shipper certifies that the particulars on the face hereof are correct and that insofar as any part of the consignment contains Dangerous Goods, such part is properly described by name and is in proper condition for carriage by air/sea according to the applicable Dangerous Goods Regulations.
Name Signature
Executed on    (date) at    (Place)