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2. Origin of Cargo:
Same as Your Company
Origin Name:
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Alaska
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3. Shipper/Exporter:
Same as Your Company
Shipper Name:
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City:
State:
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Alaska
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Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
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Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
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Nebraska
Nevada
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New Jersey
New Mexico
New York
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Ohio
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Rhode Island
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4. Consignee/Receiver:
Consignee Name:*
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City:*
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Delaware
Florida
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Kentucky
Louisiana
Maine
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Michigan
Minnesota
Mississippi
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Nebraska
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New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
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Texas
Utah
Vermont
Virginia
Washington
West Virginia
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Zip Code:
Country:*
Contact Full Name:*
Tel:*
Mobile:
Email:*
5. Cargo Commodity/Description:*
6. Hazardous Material:*
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No
Yes
7. Cargo:
Pieces:*
Dimensions (L x W x H in inches):*
Weight Per Piece (Lbs):*
8. Customs Value ($):*
10. Cargo Ready Date:*
9. Additional Insurance Required:*
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No
Yes
11. Delivery Date Required:*
12. Comments/Special Instructions
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