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detailed
information
in
all
appropriate
columns.
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print
in
lish.EE,
RE
ACNts
Date o Shipment
oticeÈR
Notifled Broker
2001e Other Charge
ko TOTAL
Optional Service 7atbtEZ
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Shippers
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Customer Gode
Dimensions t
Charges
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Shipper
Dmporter
Other
Section Code
Customer Coce
Company Name
Charge Transportation
Shipper
Importer
Other
XAEDDSEDDS
hz97-5XeImporter
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Re eiver
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diferent.
Section Code
Customer Code
Payment 3
F66)2-825 5555EXT-6p02
If
check
"Other
please
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Phone No/Ext Nol
Phone No.Est No
Postal Coce'
Tax iD
Postal Code /
Country/Area
Country/Area
Region
DINP ktWAENG
Region
City
DANGDESH PANA
NI
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HA
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607
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Shipper's Copy
Address Contact Name
HoUSE
22
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Address Contact Name
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HI
HIRo
KAWAHARA
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OKYO
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LT
|Company Name
70Y0
TA
75USHO
THHAILAND
CO
LTD
Customer Code Shipper A
Customer Code
Receiver
OCS
cannot
dellver
to
a
P.O.BOX.
IEX
Declared Value for
Customs Currenov
Amount Amount
Non Negotiable Air Waybill
44-005-184-996 a44
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51
84
996
aDESTINATION
Deser
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vvNA GROUP
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n Non Document
Commercial
VI99199109
Shipment Information tb
DCS
ORIGIN
Please
keep
IPPER'S
OPY
for
your
ference.
Taxes
Customer Code.
Declared Value for
Carriape
Currency IEX ECO
(DD Y) Date of pment
per's ture
If the receiver/other party refuses to pay the transportation charge and/or duty &tax, the charges will be billed to the shipper.
Y) Date of
iver's ature
Notified Broker
kgTOTAL
Piecels)
:Weight
Other Charge
Optional Service
Other Charge
cm
Duties
&
Taxes
Shipper's Reference
Transportation Charge :
Customer Code
Dimensions
Charges
Duties & Taxes
Shippe
Importer
|Other
|Section Code
Customer Code
Company Name
Charge Transportation
Shipper
Importer
Other
Section Code
Customer Code
tG2- 55.555ExT:b03
Payment
If
check
"Other",
please
state
Customer
Code.
Importer
Please
sta e
if
Receiver
and
Importer
are
different.
Phone No./Ext No.
Phone No./Ext No.
Postal Code
Tax ID
Postal Code
Country/Area
|Country/Area
Region
Region
City
City
2Address ß Contact Name
T HAKA
Customs
Address
6OX4sk- DIN DAENG
RD
DINDAENN
Section
Section
Company Name
Company Name
Customer Code
|Customer Code
Shipper
Receiver
OCS
cannot
deliver
to
a
P.O.BOX.
Declared
Value
for
Customs
Currency
Amount
Declared
Value
for
Carriage
Currency
Amount
Non Negotiable
IEX
44--005-184-996
IEX ECO
Air Waybill
a
4
4
0
0
5
1
8
4
9
9
6
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|DESTINATION
nDescription of Goodls)
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ANA GROUp
Non Document
Commercial
Shipment
DCS
ORIGIN
eceipt
KaK-Lo4ao
KtWWAE
N) DIN
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KHET
GkEEN INERASTRUCTURE DYIsoN
Information