Expected Date of Loading On-Board Vessel:
1. Name of ISF Importer:  Check if same as Consignee

Complete Address with Zip Code:
        
2. Name of Consignee:

Complete Address with Zip Code:

3. Name of Seller (Owner):

Complete Address with Zip Code:

4. Name of Buyer (Owner): Check if same as Consignee

Complete Address with Zip Code:

5. Name of Ship to Party: Check if same as Consignee

Complete Address with Zip Code:

6. Name of Manufacture (Supplier): Check if same as Seller

Complete Address with Zip Code:

7. Name of Container Stuffing Location: Check if same as Seller

Complete Address with Zip Code:

8. Name of Consolidator: Check if same as Seller

Complete Address with Zip Code:

9. Master Bill of lading SCAC Code AMS Master Bill of Lading Number: 
and/or  House Bill of Lading SCAC Code AMS House Bill of Lading Number:
(Must include SCAC Codes on both Master and House) Special Note: If consolidated, the AMS House Bill of Lading must be included.
10. Container Number (Optional):
Size and type of Container: 20' (Open Top) 20' (Closed Top)  Click here for additional container numbers
                                         40' (Open Top) 40' (Closed Top) Other (Please specify):
Please also provide a commercial invoice with adequate descriptions and countries of origin of all items.
Name of person completing this form:
Company Name:
Complete Address:
Telephone Number: Fax Number: Email Address:
Date:  
By completing this form, the person indicated above certifies that to the best of their knowledge all information contained in this form
is true and accurate. This completed form along with a copy of the commercial invoice must be received by David W. Bailey CHB at least
(3) business days prior to the loading of the goods on board the vessel. If any changes come to the attention of the person completing
this form, please contact David W. Bailey CHB as soon as possible but no later than (3) business days prior to the arrival of the shipment
to the US port of unloading.