Shipper's Letter of Instructions

1a. USPPI (Complete name and address)

ZIP

1b. USPPI EIN (IRS) No.

1c. Parties to Transaction Related Non-Related

2. Date of Exportation

3. Transportation Ref. No.

4a. Ultimate Consignee (Complete name and address)

Check Applicable Box

Insurance:

Yes No

Freight Charges:

Prepaid Collect

Service Level:

4b. Intermediate Consignee (Complete name and address)

5a. Forwarding Agent (Complete name and address)

6. Point of Origin or FTZ No.

7. Country of Ultimate Destination

5b. Forwarding Agent's EIN (IRS) No.

8. Loading Pier (Vessel)

9. Method of Transportation

14. Carrier ID Code

15. Shipment Ref. No.

10. Exporting Carrier

11. Port of Export

16. Entry Number

17. Hazardous Materials

Yes No

12. Port of Unloading

13. Containerized (Vessel)

Yes No

18. In Bond Number

19. Routed Export Transaction

Yes No

20. Schedule B Description of Commodities (Use columns 22–24)

D/F or M (21)	Schedule B No. (22)	Qty / Unit(s) (23)	Weight (kg) (24)	VIN / Product No. (25)	Value (USD) (26)

These commodities, technology or software were exported from the United States in accordance with the export Administration Regulations. Diversion contrary to U.S. law prohibited.

27. License No. / Exception / Authorization

28. ECCN (When required)

29. Duly Authorized Officer or Employee

The USPPI authorized the forwarder named above to act as forwarding agent for export control and customs purposes.

30. I certify that all statements made and all information contained herein are true and correct and that I have read and understand the instructions for preparation of this document. I understand that civil and criminal penalties, including forfeiture and sale, may be imposed for making false or fraudulent statements herein, failing to provide the requested information or for violation of U.S. laws on exportation (13 U.S.C. Sec. 305; 22 U.S.C. Sec. 401; 18 U.S.C. Sec. 1001; 50 U.S.C. App. 2410).

Signature

Title

Date

Tel. #

E-mail Address

31. Authentication (When required)

Important Handling Instructions
Special Handling Required as Indicated

PLEASE SIGN THE FIRST EXPORT DECLARATION IN BOX 29 WITH PEN AND INK

NOTE: The Shipper or its Authorized Agent grants authority to 3^rd PARTY SOLUTIONS & LOGISTICS in its name and on its behalf, to act as its forwarding agent for export control and customs purposes, and to prepare, sign, and/or accept any documents relating to this shipment and to forward this shipment in accordance with the terms, conditions and limitations contained in the contracts of carriage and/or tariffs of any other carriers employed in the transportation of this shipment. The shipper guarantees payment of all collect charges in the event the consignee refuses payment.