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Shipping & Logistics (Filer)
Import / Export Customs Declaration
Filer Reference No.
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Exporter Details
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Tax ID (EIN/EORI)
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Ultimate Consignee & Destination
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Ultimate Country of Destination
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Port of Export
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Port of Import
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Mode / Incoterm
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Export License / ECCN
NLR (No License Required)
ITN / AES Filing No.
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HS Code / Schedule B Description of Commodity Qty Origin Unit Value (USD) Total Value (USD)
8471.50 {{ $shipment->shipment_name }} {{ $shipment->quantity }} {{ strtoupper($shipment->origin_country) }} 500.00 12,500.00
TOTAL STATISTICAL VALUE (FOB Equivalent) 12,500.00
AWB / BL Reference
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Declaration Date
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Filer Contact
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Contact Phone / Email
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CERTIFICATION STATEMENT: I certify that all statements made and all information contained in this declaration are true and correct. I understand and acknowledge that knowingly making false or fraudulent statements is punishable by fine or imprisonment, or both. This declaration is filed on behalf of the Exporter/Principal Party in Interest.
/s/ {{ $globalSiteName }} Agent
Signature of Filer / Agent
{{ $globalSiteName }}, Licensed Customs Broker
Date: {{ $shipment->created_at->format('Y-m-d') }}