Shippers Name
:
Shippers Address
:
Shipper Contact
:
*
Shippers Phone
:
*
Shippers Fax
:
*
Shippers Email
:
*
Confirmation to be sent by
:
Fax
Email
*
Consignee’s Name
*
Consignee’s Address
:
*
Consignee’s Phone
:
*
Road Freight
:
Yes
Sea Freight
:
LCL
FCL
Air Freight
:
Yes
Shipping Terms
:
Port of Loading
:
Port of Destination
:
Final Destination
:
Number of Packages
:
Description of Goods
:
Gross Weight
:
CSM
:
Hazardous
:
Yes
No
*
If you answered Yes, please provide MO41
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Total Care to provide EDN
:
Yes
No
*
Toral Care to provide cartage
:
Yes
No
*
Document Dispatch
Return to Shipper
Express Release
Name
:
Company
:
Date
:
Commercial invoice to be either faxed or emailed to Total Care Logistics
Confirmation Code
:
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