Requested By:
Name:
Company Name:
Country:
Address Line 1:
Address: Line 2
State/Province:
Zip:
Phone Number:
Fax Number:
Origin Information:
City
Address 1:
Address 2:
Zip Code:
Country:
Shipment Date:
Email:
How would you prefer that we contact you:	Via Email Via Fax Via Phone
Destination Information:
Country:
Address:
Delivery Date:
Product Description:
Type of Shipment:	Unit Load Device Loose Cargo
Gross Weight	lbs kilos tons
Type of Packaging:	Cardboard Boxes Wooden Boxes Pallets Crates Other:
If Other, Please Specify:
Commodity:
Level Requirements:	Direct Consolidation
Terms of Sale IAW Incoterms 2000:	EXW - EX Works FCA - Free Carrier FAS - Free Alongside Ship FOB - Free on Board CFR - Cost and Freight CIF - Cost, Insurance and Freight CPT- Carriage Paid To CIP - Carriage and Insurance Paid To DAF - Delivered at Frontier DES - Delivered Ex Ship DEQ - Delivered Ex Quay DDU - Delivered Duty Unpaid DDP - Delivered Duty Paid
Does the shipment contain dangerous goods as per IATA DGR?	No Dangerous Goods Dangerous for Passengers and Aircraft Dangerous for Cargo Aircraft Only
Additional Product Information:
Dimensions:
Length:
Width:
Height:
Pieces:
Additional Information:
Comments: