Vitalux Export Form

Vitalux Shipping Declaration Form
Location*
Email
example@example.com
VITALUX LOGISTICS
SHIPPING INSTRUCTION FORM/ FORMULARIO DE INSTRUCCION DE ENVIO CLEAR, LEGIBLE AND IN CAPITAL LETTERS/ IESCRITURA LEGIBLE YEN LETRA DE MOLDE
SHIPPER'S INFO/ INFORMACION DE REMITENTE
Shipper Name/ De Remitente Nombre*
Address in Suriname/ Dirección en Surinam*
Neighborhood + District / Barrio + Distrito*
City + Country / Ciudad + País*
Telephone number I No. de telefono*
ID Number/ No Cl *
Shipper Photo ID / Remitente Cédula De Indentidad*
CONSIGNEE'S INFO/ INFORMACION DE DESTINATARIO
Consignee Name/ Infrormacion De Destinatario Nombre*
Street and Number / Calle y Número*
Neighborhood + Municipality / Reparto + Municipio*
Province + Postal Code + Country / Provincia + Código Postal + País*
Telephone number I No. de telefono*
ID Number/ No Cl *
Consignee Photo ID / Consignatario/a Cédula De Indentidad*
AWB number
Flight date/ Fecha Vuelo

MonthDayYear
Date
Flight number/ No. de Vuelo

Type and quantity of pieces / Tipo y cantidad de piezas

Take Photo Package No. 1 / Paquete de fotografía No. 1
Take Photo Package No. 2 / Paquete de fotografía No. 2
Take Photo Package No. 3 / Paquete de fotografía No. 3
Take Photo Package No. 4 / Paquete de fotografía No. 4
Airport of Departure/ Aeropuerto de Salida
Airport of Destination/ Aeropuerto de Destine*
Airport of Destination/ Aeropuerto de Destine
Desired Route I Ruta Deseada
Transportation value/ Valor de Transportación
Transportation value/ Valor de Transportación
Custom Value/ Valor de Aduanas*
Secured Value I Valor Asegurado
Request form number/ Formulario de pedido no.
Additional documents /Documentos adicionales
Shipper's Safety Declaration / Declaración de seguridad al remitente:

The carrier declares that the shipment does NOT contain explosives or other dangerous substances with destructive effect. The shipper agrees to inspect the contents of the shipment and understands that they will be stored in an archive for at least the duration of the shipmentis delivery.
Date*

DayMonthYear
Date
Hour Minutes
Signature*

Clear
Issuing date/ Fecha de emisión:
Should be Empty:

Vitalux Shipping Declaration Form