DATE OF EXPORTATION	EXPORT REFERENCES (i.e., order no., invoice no., etc)
SHIPPER / EXPORTER  (complete name and address)	CONSIGNEE (complete name and address)
COUNTRY OF EXPORT	IMPORTER – IF OTHER THAN CONSIGNEE  (complete name and address)
COUNTRY OF ORIGIN OF GOODS
COUNTRY OF ULTIMATE  DESTINATION

 

 INTERNATIONAL         

 

MARKS / NOS	NO.OF PKGS	TYPE OF PACKING	FULL DESCRIPTION OF GOODS	QTY.	UNIT OF MEASURE	WEIGHT	UNIT VALUE	TOTAL VALUE
	TOTAL NO.OF PKGS.					TOTAL WEIGHT		TOTAL INVOICE VALUE
								Check one  F.O.B.  C & F  C.I.F.

 

RETURN TO _________________________________________________________

 

THESE COMMODITIES ARE LICENSED FOR THE ULTIMATE DESTINATION SHOWN.

DIVERSION CONTRARY TO UNITED STATES LAWS IS PROHIBITED

 

I DECLARE ALL THE INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECT

 

SIGNATURE OF SHIPPER / EXPORTER  (Type name and title and sign)                                                                 DATE

       

 

 

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