This invoice must be completed in English.

COMMERCIAL INVOICE 1
Page _______ of _______
EXPORTER: Ship Date:
Tax ID#: SELECT DOWN ARROW FOR OPTIONS 4/5/2023
Contact Name: Richard Small Air Waybill No. / Tracking No.:
Telephone No.: 907-230-4757 396675155351
Invoice No.: Purchase Order No.:
E-Mail: rlsmall@live.com
Company Name/Address:
Payment Terms: Bill of Lading:

Purpose of Shipment:
GIFT (UNSOLICITED)

Country: US
Parties to Transaction:
Related ✔ Non-Related
SOLD TO
SOLD TO /(ifIMPORTER
different from Consignee):
(if different from Consignee):
CONSIGNEE:
Tax ID#: SELECT DOWN ARROW FOR OPTIONS Same as CONSIGNEE:
Contact Name: Juliana Gomez Mona
Telephone No.: 573-0237-37459 Tax ID#: SELECT DOWN ARROW FOR OPTIONS
E-Mail: juliana-1423@hotmail.com
Company Name/Address: Company Name/Address:

Country: Colombia Country:

If there is a designated broker for this shipment, please provide contact information.
Name of Broker ____________________________________________________ Tel. No. __________________________ Contact Name ____________________________________________ ___

Duties and Taxes Payable by Exporter ✔ Consignee Other If Other, please specify _______________________________________________________________________
No. of No. of Net Weight Unit of Harmonized Country of Unit Total
Description of Goods
Packages Units (LBS / KGS) Measure Tariff Number Manufacture Value Value

1 1 3lbs iPad 42021290 300.00 300.00

0.00 0.00

0.00 0.00

0.00 0.00

Total Total Total Net (Indicate Total Gross (Indicate Terms

Select Down Arrow For Options Subtotal:
Pkgs Units Weight LBS/KGS) Weight LBS/KGS) of Sale: 300.00

1 1 3,000 Insurance: 0.00

Special Instructions:
Freight: 0.00

Packing: 0.00
Declaration Statement(s):
Handling: 0.00
Other:
These items are controlled by the U.S. government and authorized for export only to the country of ultimate destination for use by the
ultimate consignee or end-user(s) herein identified. They may not be resold, transferred, or otherwise disposed of, to any other country 0.00
or to any person other than the authorized ultimate consignee or end-user(s), either in their original form or after being incorporated
into other items, without first obtaining approval from the U.S. government or as otherwise authorized by U.S. law and regulations. Invoice Total: 300.00
I declare that all the information contained in this invoice to be true and correct.
Originator or Name of Company Representative if the invoice is being completed on behalf of a company or individual: Currency Code:

Signature / Title / Date:

Rev. Date 11.06.18 v1.09

 COMMERCIAL INVOICE
This invoice must be completed in English. CONTINUATION SHEET 2
Page _______ 2
of ________
EXPORTER: Air Waybill No. / Tracking No.:
396675155351
Invoice No.: Purchase Order No.:

Payment Terms: Bill of Lading:

Country: US
CONSIGNEE: SOLD TO / IMPORTER
SOLD TO (if different(iffrom Consignee):
different from Consignee):

Country: Colombia Country:

No. of No. of Net Weight Unit of Harmonized Country of Unit Total
Description of Goods
Packages Units (LBS / KGS) Measure Tariff Number Manufacture Value Value

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

SUBTOTAL FOR THIS PAGE: 0.00

Rev. Date 11.06.18 v1.09