Industreies Receipts

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Date of Export Export References

Shipper/Exporter Recipient
Tax ID/VAT No (Your Tax ID) Tax ID/VAT
Contact Name (Your Contact Name) Contact Name
Company Name (Your corporation Name) Company Name
Address (Your Street Address) Address

City State/Province (Your City State) City State/Province


Postal Code (Your Postal Code) Postal Code
Country/Territory (Your Country) Country/Territory
Phone (Your Phone) Phone
Country of Export Importer (If other than recipie nt)
Tax ID/VAT
Country of manufacture Contact Name
Company Name
Country of ultimate destination Address
City State/Province
Postal Code
Country/Territory
Phone
Harm. No. of Type of Full Description Units of
Qty Unit Value Total Value
code pkgs packaging of goods measure
0 0) ( )
0 0) ( )
0 0) ( )
0 0) ( )
0 0) ( )
0 0) ( )
0 0) ( )
0 0) ( )
0 0) ( )
0 0) ( )
0 0) ( )
0 0) ( )
Total INVOICE
Total
No. of 0
Weight VALUE
Pkgs
I declare all the information contained in this invoice to be true and correct
Signature of shipper/exporter

SHIPPER

Check One

DATE

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