Shipper's Letter of Instructions

Revised 10-15-2018

Shipper - Person or Company Tendering Freight

Name:

Account:

Phone:

Complete Address:

Email:

Airport of Departure:

Consignee - Person or Company Receiving Freight

Name:

Account:

Phone:

Complete Address:

Email:

Airport of Arrival:

Freight Service - The Shipment(s) will be transported/billed based on the “Freight Service” selected below.

Express Air Service (GCX) Regular Air Service (GEN) Small Package Service(SPS) Barrel

Rush Expedited (RXS) /MIA Only To Door Delivery Bonded Trucking Ocean Freight Service

To-Door Deliveries: The shipper is required to provide all permits/licenses/visa’s, a commercial invoice with actual values and shippers Tax I.D. Number at the time of tendering the shipment to Amerijet, prior to export. Amerijet is not responsible for any transportation, customs or delivery delays and/or any additional charges due to incomplete, incorrect or missing documentation or if the shipment is not in proper condition for transportation according to the applicable regulations. Refer to www.amerijet.com for country restrictions.

Payment Information - How are you paying for the freight charges? (Please check one only)

Check

Credit Card

Freight Prepaid

Freight Collect

On Account, Account#:

Would you like to insure this shipment:

Yes. If, Yes, Amount: $

No. If denied Initial here:

Declare value for Customs:

Do you have a Quote Number, Air Waybill Number, PRO Number, Ocean Booking Number or Reservation Number? Yes No

Please list your number:

Are you consolidating this shipment with other freight you have already at Amerijet (this location)? Yes No

Description of the Freight

Quantity	Brief Description	Measurement: in cm			Weight lb kg
Quantity	Brief Description	Length	Width	Height	Weight lb kg




Total:
* If more space for Dimensions is needed, please use the back of the paper. (Dimensions are subject to Amerijet verification.)

Refrigeration Required? Yes No Do you have a commercial invoice? Yes No

Is the freight Hazardous Material? (Example – Paint, Hair Spray, Nail Polish)? Yes No

Does this shipment contain Pharmaceuticals? Yes No

By signing this form I/we hereby consent to screening this shipment as per Transportation Security Administration (TSA) requirements.

Special Instructions:

PLEASE FILL OUT THIS FORM COMPLETELY!

Rule 110(H): Shipments, the contents of which are liable to deteriorate or perish due to change in the climate, temperature, altitude or other ordinary exposure, or because of length of time in transit, will be accepted without responsibility on the part of carrier for loss or damage due to such deterioration or perishability.

I/We are hereby certifying that this shipment does not contain Samsung Galaxy Note 7 cellphone. Amerijet is not liable for any losses, damages or seizures of these devices. The shipper will be responsible for any damages and/or liabilities arising from the failure to declare the full content of the shipment(s).

Signature Required

Print Name

Date

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